Quality of life and social health in patients after pancreatic surgery

Abstract

Background

Clinicians lack robust data on quality of life (QOL) and social functioning after pancreatectomy limiting their ability guide patient decision making aligned with patients’ goals of care.

Methods

In this cross-sectional survey study, we administered the European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire, pancreas-specific QLQ-PAN26, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles, and PROMIS activities and social isolation scales to all elective pancreatectomies (2021–2023). Results were compared with both normative data and between groups to determine factors predicting better QOL with a >10–12-point change considered clinically significant.

Results

A total of 143 patients were included; 71 (49.6%) completed the distributed surveys. The average age of responders was 59.9 ± 16.1 years with 56.3% men. Pancreaticoduodenectomy (54.9%) was performed for malignancy in 67.6% of cases. Compared with normative population controls, postpancreatectomy patients reported lower role functioning scores (67.2 ± 28.7 vs 81.7 ± 28.2, 14.5 score difference) but less social isolation (40.6 ± 5.7 vs 50.0 ± 10.0, 9.4 score difference). Compared with patients with benign disease, those with malignancy reported clinically significant worse social functioning; more fatigue, pain, constipation, change in taste, weight loss, weakness, and altered bowel habits; worse body image; and increased worries about the future. Despite more symptoms, they were more satisfied with the healthcare they received (all >10-point score difference).

Conclusion

QOL and social health are affected by pancreatic resection and outcomes differ whether surgery was performed for benign or malignant disease. These issues are largely unaddressed and are potential targets for intervention to improve QOL.