Long-term quality of life and global health following pancreatic surgery for benign and malignant pathologies

Kaitlin Shaw; Alexander S Thomas; Vilma L Rosario; Kazuki N Sugahara; Beth A Schrope; John A Chabot; Jeanine M Genkinger; Wooil Kwon; Michael D Kluger

doi:10.1016/j.surg.2021.03.023

Long-term quality of life and global health following pancreatic surgery for benign and malignant pathologies

Surgery. 2021 Sep;170(3):917-924. doi: 10.1016/j.surg.2021.03.023. Epub 2021 Apr 21.

Authors

Kaitlin Shaw¹, Alexander S Thomas², Vilma L Rosario², Kazuki N Sugahara², Beth A Schrope², John A Chabot², Jeanine M Genkinger³, Wooil Kwon⁴, Michael D Kluger⁵

Affiliations

¹ Division of GI/Endocrine Surgery, Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. Electronic address: https://twitter.com/KaitlinShawMPH.
² Division of GI/Endocrine Surgery, Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
³ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
⁴ Division of GI/Endocrine Surgery, Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Electronic address: wk2353@cumc.columbia.edu.
⁵ Division of GI/Endocrine Surgery, Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. Electronic address: https://twitter.com/drkluger.

PMID: 33892953
DOI: 10.1016/j.surg.2021.03.023

Abstract

Background: While the frequency of pancreatic operations are increasing, understanding quality of life is still insufficient. The aim was to evaluate global health and quality of life of long-term survivors from a range of pancreatic operations using internationally validated instruments.

Methods: Patients surviving longer than 5 years after pancreatic operations were surveyed using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Cancer-30 and Pancreatic Cancer-26 modules. Variables were analyzed according to demographic and clinical features.

Results: Eighty patients completed questionnaires. The median follow-up was 9.3 years from the time of operation. The mean scores of global health status/quality of life, physical function, role function, emotional function, cognitive function, and social functioning were 73.9, 83.7, 84.6, 81.1, 80.2, and 86.3, respectively. The participants' reported quality of life was comparable or better than the general United States population. The summary score, which was defined as weighted average of function and symptom scores (excluding global health status/quality of life and financial impact scores), showed significant differences according to the level of education (70.1 no college vs 85.2 college and 85.7 grad school, P = .049), operation type (79.9 pancreatoduodenectomy vs 91.1 total, P = .043), additional endoscopic retrograde cholangiopancreatography (77.3 vs 86.0, P = .029), and additional abdominal operations related to the primary operation (79.0 vs 86.6, P = .026).

Conclusion: Long-term survivors of pancreatectomy had comparable or better global health status/quality of life, function scale, and lower symptom scores than the general population of the United States, though persistent gastrointestinal symptoms are common. These findings should help inform patients of the long-term consequences of pancreatectomy, so they can make better decisions especially when considering prophylactic operations.

MeSH terms

Adult
Aged
Aged, 80 and over
Female
Health Status
Humans
Male
Middle Aged
Pancreas / surgery
Pancreatectomy
Pancreatic Diseases / surgery*
Pancreatic Neoplasms / surgery*
Pancreaticoduodenectomy
Quality of Life*
Surveys and Questionnaires
Treatment Outcome