Quality of life, nutritional status, and gastrointestinal hormone profile following the whipple procedure

McLeod, Robin S.; Taylor, Bryce; O’Connor, Brenda I.; Greenberg, Gordon R.; Jeejeebhoy, Khursheed N.; Royall, Dawna; Langer, Bernard

doi:10.1016/s0002-9610(99)80129-9

Cited by 143 publications

(62 citation statements)

References 18 publications

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“…This small study indicated a 50% increase in the QALY cost of treatment compared to other disease sites, but acknowledged that such results need to be interpreted cautiously considering the limited knowledge of quality of life assessment in pancreatic cancer. McLeod et al (1995) showed that mean utility measures as assessed by the time-trade-off technique were between 0.98 and 1, suggesting a near normal well-being. However, this apparent stability must be viewed with caution as the pancreatic cancer patients are biased in terms of best outcome, had no recurrence at time of follow-up and had good functional scores.…”

Section: Quality Of Life Assessments In Pancreatic Cancermentioning

confidence: 98%

“…It was acknowledged that there were problems regarding the poor compliance at the beginning of the study as patients were unable to complete such an array of questionnaires and that, in the advanced stages of disease, problems affecting quality of life may be more prevalent. Similarly, in a study examining the quality of life in 25 patients after the KauschWhipple operation compared that of to age/sex-matched post-cholecystectomy patients (McLeod et al 1995), a variety of quality of life assessment tools were used, including a clinical assessment of nutritional status. The results indicated that quality of life was excellent in the Whipple group and not significantly different from that of the control group.…”

Section: Quality Of Life Assessments In Pancreatic Cancermentioning

confidence: 99%

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Quality of life after treatment of pancreatic cancer

Fitzsimmons

Johnson

1998

Langenbecks Arch Chir

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In the past decade there has been increasing focus on assessment of the quality of life (QoL) of patients with cancer. QoL is now a mandatory endpoint in many cancer clinical trials, particularly in interventions with palliative intent alone. Although QoL is difficult to define, a variety of specially designed and validated questionnaires has been developed to measure QoL in the clinical setting. In pancreatic cancer, assessment (QoL) is of paramount importance; however, little research has been conducted and until recently no disease-specific QoL questionnaire existed. In this review we consider the quality of life of patients with pancreatic cancer, with particular reference to the symptoms and psychosocial consequences of the disease. The literature is critically examined on the approaches to evaluation of QoL in previous pancreatic cancer clinical trials. We then describe the impact on QoL following both "curative" and palliative surgical interventions and medical treatment, including endoscopic palliation and chemotherapy for pancreatic cancer. In the European Organisation for Research and Treatment of Cancer (EORTC) the questionnaire specific for pancreatic cancer, the QLQ-PAN26, is discussed as a standardised and valid assessment of QoL in international clinical trials. Finally, recommendations are made for future QoL research in pancreatic cancer.

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Section: Quality Of Life Assessments In Pancreatic Cancermentioning

confidence: 98%

Section: Quality Of Life Assessments In Pancreatic Cancermentioning

confidence: 99%

Quality of life after treatment of pancreatic cancer

Fitzsimmons

Johnson

1998

Langenbecks Arch Chir

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“…Schmier et al [4] summarized those studies using only psychometrically validated, multi-dimensional instruments such as the European Organization for Research and Treatment of Cancer (EORTC) questionnaire in their review. 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%

Health-Related Quality of Life in Patients with Pancreatic Cancer

Müller‐Nordhorn¹,

Roll²,

Böhmig

et al. 2006

Digestion

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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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“…Pancreatoduodenectomy is associated with exocrine and endocrine alterations [8,9,10,11]. During follow-up, patients frequently report difficulties with food intake, periods of diarrhea, altered consistency of feces, steatorrhea and symptoms of malabsorption and subsequent malnutrition [12].…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Fibrosis Correlates with Exocrine Pancreatic Insufficiency after Pancreatoduodenectomy

Tran¹,

Hof²,

Kazemier³

et al. 2008

Dig Surg

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Background: Obstruction of the pancreatic duct can lead to pancreatic fibrosis. We investigated the correlation between the extent of pancreatic fibrosis and the postoperative exocrine and endocrine pancreatic function. Methods: Fifty-five patients who were treated for pancreatic and periampullary carcinoma and 19 patients with chronic pancreatitis were evaluated. Exocrine pancreatic function was evaluated by fecal elastase-1 test, while endocrine pancreatic function was assessed by plasma glucose level. The extent of fibrosis, duct dilation and endocrine tissue loss was examined histopathologically. Results: A strong correlation was found between pancreatic fibrosis and elastase-1 level less than 100 µg/g (p < 0.0001), reflecting severe exocrine pancreatic insufficiency. A strong correlation was found between pancreatic fibrosis and endocrine tissue loss (p < 0.0001). Neither pancreatic fibrosis nor endocrine tissue loss were correlated with the development of postoperative diabetes mellitus. Duct dilation alone was neither correlated with exocrine nor with endocrine function loss. Conclusion: The majority of patients develop severe exocrine pancreatic insufficiency after pancreatoduodenectomy. The extent of exocrine pancreatic insufficiency is strongly correlated with preoperative fibrosis. The loss of endocrine tissue does not correlate with postoperative diabetes mellitus. Preoperative dilation of the pancreatic duct per se does not predict exocrine or endocrine pancreatic insufficiency postoperatively.

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Quality of life, nutritional status, and gastrointestinal hormone profile following the whipple procedure

Cited by 143 publications

References 18 publications

Quality of life after treatment of pancreatic cancer

Quality of life after treatment of pancreatic cancer

Health-Related Quality of Life in Patients with Pancreatic Cancer

Pancreatic Fibrosis Correlates with Exocrine Pancreatic Insufficiency after Pancreatoduodenectomy

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