Systematic review on the impact of pancreatoduodenectomy on quality of life in patients with pancreatic cancer

Abstract

Pancreatoduodenectomy for malignant disease negatively influences QoL in the physical and social domains at short term. It will eventually recover to baseline values after 3-6 months. This information is valuable for counselling and expectation management of patients undergoing pancreatoduodenectomy.

Landscape of Health-Related Quality of Life in Patients With Early-Stage Pancreatic Cancer Receiving Adjuvant or Neoadjuvant Chemotherapy

“…The baseline QoL was defined using presurgical data (n = 6) or the first postsurgical data (n = 5). The baseline EORTC QLQ-C30 GHS/QoL scores in early-stage PC (median [interquartile range], 61 [59][60][61][62][63][64]) seemed similar to reference norms reported for PC (all stages and including liver and biliary cancers; 58 ; n = 750) but lower than those reported for all cancers (all stages; 67 ; n = 23,553). 23 Overall, 13 studies reported longitudinal QoL data; of these, 11 studies reported longitudinal EORTC QLQ-C30 GHS/QoL data ( Table 3).…”

“…The QoL dynamics reported here are generally consistent with those from a recent systematic literature review that assessed the effect of pancreatoduodenectomy on QoL (17 studies published up to June 2016; 1240 patients), which showed no change in global health and overall QoL during 12 postoperative months in 6 of the 12 studies; the remaining 6 studies reported a postoperative decline in QoL that recovered after 3 to 6 months. 62 Similar trends were seen in physical and social functioning domains and in pain, fatigue, and diarrhea symptoms scales. 62 The initial decline in QoL is consistent with a delayed initiation of adjuvant chemotherapy in a considerable proportion of patients with resected PC, 63,64 and the recovery and stability suggest that QoL may not be negatively affected by chemotherapy, at least in the longer term.…”

“…62 Similar trends were seen in physical and social functioning domains and in pain, fatigue, and diarrhea symptoms scales. 62 The initial decline in QoL is consistent with a delayed initiation of adjuvant chemotherapy in a considerable proportion of patients with resected PC, 63,64 and the recovery and stability suggest that QoL may not be negatively affected by chemotherapy, at least in the longer term. Additional research is needed to understand the effect on QoL of other important factors, such as use of neoadjuvant chemotherapy and intensity of adjuvant chemotherapy.…”

“…55 A recent study underscored the unavailability of reference values for EORTC QLQ-PAN26 in the United States, 45 further suggesting that MID has not been assessed comprehensively and that there is a need to fully establish the reference values for this PROM. The systematic literature review by van Dijk et al 62 did not assess MID values. Both EORTC QLQ-C30 and QLQ-PAN26 seem to be useful PROMs in assessing QoL in early-stage PC.…”

Relationship Between Quality of Life and Survival in Patients With Pancreatic and Periampullary Cancer: A Multicenter Cohort Analysis

“…Pancreatic resection has been found to be associated with a temporary deterioration in QoL, which usually returns to baseline values after 3 to 6 months. 2,3 Moreover, chemotherapy has been found to improve QoL in randomized studies in the adjuvant and palliative setting. 4,5 QoL may also be used to predict survival.…”