Patient expectations about the oncologic benefit of pancreatectomy for pancreatic ductal adenocarcinoma.

Background: Pancreatic resection offers the only chance for cure for pancreatic ductal adenocarcinoma, but resection is associated with significant morbidity. Data are lacking about whether patients understand the risks/benefits of surgical resection. This survey study prospectively assessed patient understanding of expected oncologic outcomes after pancreatectomy.

Methods: A 14-question survey was distributed between 2020 and 2022 to patients planning to undergo pancreatectomy at eight geographically diverse institutions performing high-volume pancreatic surgery. The survey assessed demographics, expectations about post-resection outcomes, and perceived quality of patient-surgeon communication. Associations between demographics and survey responses were assessed with Fisher's exact test and Goodman-Kruskal's lambda.

Results: 152 surveys were received (response rate 39 %; n = 152/376). Almost all patients believed surgery was likely to prolong survival (146/147, 99 %); cure their cancer (126/141, 89 %); and/or ameliorate health problems due to cancer (127/136, 93 %). Regarding patient-surgeon communication, 134/150 (89 %) reported surgeons always listened carefully, and 134/150 (89 %) reported surgeons gave clear explanations. There were no meaningful associations between demographics and understanding of expected post-resection outcomes.

Discussion: Most patients believed surgery was likely curative and were satisfied with patient-surgeon communication. These data outline a critical opportunity for surgical oncologists to improve pre-operative counseling and ensure patients have accurate information to support complex decision-making.