Surgical resection is the only curative treatment for pancreatic cancer but is very invasive. It usually causes severe stress in patients and may cause pain and deterioration of quality of life (QOL). Patient-reported QOL data are essential for describing patient symptomatology and evaluating care to adequately manage symptoms. Here we evaluated changes in health-related QOL (HRQOL) and symptoms in pancreatic cancer patients after surgical intervention.
The institutional review board of our university approved this study (2012-1-403); patients provided written informed consent. A QOL questionnaire survey was administered preoperatively and at postoperative months 3, 6, and 12. We statistically evaluated the correlations between the Short Form 36 Health Survey version 2 (SF-36v2 Standard, Japanese), which measures HRQOL, and specific symptoms of hepatobiliary and pancreatic cancer, using data collected from 100 postoperative pancreatic cancer patients (subtotal stomach-preserving pancreatoduodenectomy (PD), 54 patients; distal pancreatectomy, 36 patients; total pancreatectomy (TP), 10 patients). Responses were analyzed by two-way ANOVA and Spearman’s correlation coefficient analysis; p < 0.05 was considered significant. All statistical analyses were performed using SPSS (ver. 21).
QOL was lowest at 3 months postoperatively on many domains of the SF-36v2 and had gradually improved by 12 months postoperatively. At 3 months, physical functioning (PF) (p < 0.001) and role-physical (RP) (p < 0.01) were significantly reduced in PD and TP patients. Also, QOL deterioration on SF-36v2 domains was correlated with weight loss (PF, RP, vitality (VT), role-emotional (RE); p < 0.05), worse bowel control (PF, BP, VT, RE, mental health (MH); p < 0.01-0.05), indigestion (PF, RP, GH, VT, social functioning, RE, MH; p < 0.001-0.05), appetite loss (all domains; p < 0.001-0.01), fatigue (PF, RE, MH; p < 0.05), and inability to perform usual activities (all domains, p < 0.001).
QOL after pancreatectomy can be improved by nutrition management, treatment combinations for symptoms related to digestion and absorption, and treatment for subjective symptoms including fatigue.
Clinical trial identification
Think Science KK.
Legal entity responsible for the study
JSPS KAKENHI Grant Number JP16K07140.
F. Motoi: Speaker Bureau / Expert testimony: Taiho Pharma, Mylan Japan, Daichi-Sankyo. M. Unno: Research grant / Funding (self): Taiho Pharma, Chugai; Research grant / Funding (institution): Taiho Pharma, Pfizer, Takeda, Chugai, Yakult, Asahi-Kasei. All other authors have declared no conflicts of interest.