Correlation of Patient-Derived Utility Values and Quality of Life after Pancreaticoduodenectomy for Pancreatic Cancer

Warnick, Stephen J.; Velanovich, Vic

doi:10.1016/j.jamcollsurg.2006.02.032

Cited by 19 publications

(17 citation statements)

References 26 publications

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“…A number of other studies have used the EORTC health status instrument in patients with pancreatic cancer, however, predominantly in phase II studies or randomised controlled trials [7, 9,11,12,13,14,32,33,34,35,36]. In a cross-sectional study by Andreyev et al [7] comparing pancreatic cancer patients with to those without weight loss, global quality of life scores were higher than in our study.…”

Section: Discussioncontrasting

confidence: 80%

“…We found one study assessing utility values in patients after pancreaticoduodenectomy for pancreatic cancer [14]. Utility values were determined with two questions, a patient-derived rating of present health status and a time-exchange question.…”

Section: Discussionmentioning

confidence: 99%

“…They found two cross-sectional studies [7, 8] as well as three longitudinal studies assessing the effect of chemotherapy, surgery, and endoscopic stenting on HRQoL [9,10,11]. Recently, a number of observational studies were published [12,13,14]. …”

Section: Introductionmentioning

confidence: 99%

“…The EQ-5D is one of the handful of measures recommended for use in cost-effectiveness analyses by the Washington Panel on Cost Effectiveness in Health & Medicine as well as by the National Institute for Clinical Excellence (NICE) in the UK [15]. However, we only found one study assessing utility measures in patients with pancreatic cancer [14]. The objectives of the present study were, therefore, to assess HRQoL in patients with pancreatic cancer in the usual care setting using both a profile instrument and an utility measure, and to describe the symptoms associated with impaired quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Health-Related Quality of Life in Patients with Pancreatic Cancer

Müller‐Nordhorn¹,

Roll²,

Böhmig

et al. 2006

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Background: Pancreatic cancer is an aggressive cancer with low survival time, with health-related quality of life (HRQoL) being of major importance. The aim of our study was to assess both generic and disease-specific HRQoL in patients with pancreatic cancer. Methods: Patients with pancreatic cancer were consecutively included at admission to hospital. HRQoL was determined with the disease-specific European Organization for Research and Treatment of Cancer (EORTC) and generic EuroQoL (EQ-5D) health status instruments. Scores of patients were compared to those of norm populations. The association of symptoms with overall HRQoL was analysed using linear regression. Results: A total of 45 patients with pancreatic cancer were included. The mean age was 64 years, 53% were females. Of all patients, 44% had metastases at the time of admission. HRQoL was significantly impaired for most EORTC and EQ-5D scales in comparison to norm populations. Symptoms of fatigue (–0.34 regression coefficient; 95% CI –0.63, –0.11) and pain (–0.21; 95% CI –0.39, –0.02) were significantly associated with impaired overall HRQoL. Conclusions: HRQoL was severely impaired in patients with pancreatic cancer. Symptom control and palliative care appear to be of particular importance.

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Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health-Related Quality of Life in Patients with Pancreatic Cancer

Müller‐Nordhorn¹,

Roll²,

Böhmig

et al. 2006

Digestion

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“…18,52,53 We have previously demonstrated in pancreatectomy patients that patient-derived utility scores correlate well with patient-derived quality of life scores using a validated, generic quality of life instrument. 54 Therefore, we will use this method in this study.…”

Section: Standardization Of Outcome/utility Scorementioning

confidence: 99%

The Choice of Primary Repair or Mesh Repair for Paraesophageal Hernia

Obeid

Velanovich

2013

Annals of Surgery

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Comparative Effectiveness of Resection vs Surveillance for Pancreatic Branch Duct Intraductal Papillary Mucinous Neoplasms With Worrisome Features

Johnston

Shami

et al. 2018

JAMA Surg

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The 2012 international consensus guidelines defined a subcategory of pancreatic branch duct intraductal papillary mucinous neoplasms with "worrisome features," which may be followed with close surveillance. However, given the poor prognosis of invasive malignancy, the role of early, upfront resection requires further investigation. OBJECTIVE To compare the utility of upfront resection vs long-term surveillance. We hypothesized that surveillance of these cystic neoplasms would offer greater long-term utility. DESIGN, SETTING, AND PARTICIPANTS A Markov decision analysis model was constructed to estimate and compare 2 management strategies: early resection and long-term surveillance. Estimates for the utility of outcomes, probabilities of transitions between disease states, and probabilities of surgical morbidity were derived from a literature review of articles published between 1997 and 2014. The comparative effectiveness model's variable estimates were based on data published predominantly by high-volume, tertiary referral centers. Model probability variable estimates were derived from large, retrospective, single-institution reports. For utility variables, estimates derived from studies using standard-gamble or time-tradeoff methods were given greater weight. MAIN OUTCOMES AND MEASURES Expected utility was measured in terms of quality-adjusted life years using 3% annual discount. Probabilistic and 1-way sensitivity analyses were performed to assess the potential effects of uncertainty in estimates of key model variables. RESULTS Early resection yielded 11.63 quality-adjusted life-years during 20 years of follow-up compared with 11.06 for surveillance. Probabilistic sensitivity analysis indicated that resection has a 94% likelihood of being more effective than surveillance. Early resection obtained greater utility only if each of the following criteria are met: life expectancy is at least 18 years, surgical mortality is less than 4.3%, and baseline preoperative utility is at least 0.78. Additional drivers of the model outcomes include the rate of progression from worrisome to high-risk features and the likelihood of finding cancer on resection for neoplasms with high-risk stigmata. CONCLUSIONS AND RELEVANCE Early resection compares favorably with surveillance in the management of branch duct intraductal papillary mucinous neoplasms with worrisome features. However, careful consideration of patient factors and surgeon outcomes is imperative.

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Correlation of Patient-Derived Utility Values and Quality of Life after Pancreaticoduodenectomy for Pancreatic Cancer

Cited by 19 publications

References 26 publications

Health-Related Quality of Life in Patients with Pancreatic Cancer

Health-Related Quality of Life in Patients with Pancreatic Cancer

The Choice of Primary Repair or Mesh Repair for Paraesophageal Hernia

Comparative Effectiveness of Resection vs Surveillance for Pancreatic Branch Duct Intraductal Papillary Mucinous Neoplasms With Worrisome Features

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