Quality of life assesment after pancreatic resection for malignancy

Abstract

Background: Management of pancreatic cancer is challenging as this tumor entity is characterized by poor prognosis.pancreatic resection is only potentially curative and the resection yields significant morbidity and mortality risks and survival is limited. Therefore,the assessment of quality of life after pancreatic resection is important

Objectives: Evaluation of postoperative quality of life assessment in patients after pancreatic resection and to make detailed analysis of physical,functional,social,emotional and sexual domains after pancreatic surgery

Study Design: Prospective Observational Study Participants:

Patients who underwent pancreatic resection for pancreatic or borderline pancreatic malignancy or peri-ampullary carcinoma in the department of surgical gastroenterology SKIMS from June 2017 to June 2019.

Methods: This prospective observational study assessed quality of life after pancreatic resection at 1 month,3 months and 6 months using EORTC QLQ C-30 and pancreas specific QLQ

–PAN 26 questionnaire module.Quality of life in patients with pancreas specific complications was compared with quality of life in patients with no complications over a period of 6 months.Analysis was performed with linear mixed models for repeated measurements.

Results: 57 patients were included,out of which 34 were males and 23 were females,whipple procedure was performed in 9 paients,PPPD in 31 patients and resection of body and tail in 9 patients and SPDR in 8 patients.pancreas specific complications following resection was reported in 22 patients.A decrease in physical social,cognitive functioning was noted at 1 month and recovered to baseline values at 3-6 months postoperatively. Symptoms scales like nausea,vomting diarrhea etc increased at 1 month but recovered at 3 months. Patients with pancreas specific complications had worse QOL than the patients without complications,however differences at 6 months were clinically insignificant.

Conclusion: The pancreatic resection has negative influence on physical and psycho-social functioning domain of quality of life in first three months but recover to baseline values at 3-6 months

Implications: This information is useful for patient counselling and management both before and

after pancreatic resection in patients with pancreatic malignancy.