Quality of life is an important factor in the balance sheet indicator in patients with pancreatic cancer. Multicentric prospective study

Abstract

Introduction: The aim of this study is to present the evaluation results of a prospective multicenter study of quality of life (QoL) in the treatment of patients with ductal adenocarcinoma of the pancreas. Method and patients: 151 patients with pancreatic ductal adenocarcinomawere treated according to the staging of the tumor. Tomonitor QoL, we used a generic questionnaire SF-36/2 before treatment and 3 months thereafter. The arithmetic mean and standard deviation (SD) were used as summary statistics for the QoL scores. The results were calculated using SF-36 software, independent samples t-test, ANOVA, paired t-test and SPSS 19.0.1 (IBM Corporation, 2010). A p value <0.05 were considered statistically significant, in all the tests. Results: Initial total value of QoL is significantly lower in women than men (QoL: 50.3 18.0 vs. 58.3 20.8, p 1⁄4 0.013). Reduction in QoL after 3 months was significantly lower in men. In patients older than 60 years, we found a significant decrease in QoL after 3 months of starting treatment compared with younger one (QoL: 54.7 21.0 vs. 47.8 18.9, difference -6.9 18.5, p 1⁄4 0.009). Depending on the stage of disease, we found a significant decrease in QoL during treatment for patients in stage III and IV, in earlier forms of the diseasewe have not seen (St. III in 81 patient QoL: 55.7 19.9 vs. 49.7 18.5, difference -6.1 17.6, p 1⁄4 0.003, st. IV in 39 patients, QoL: 44.3 19.1 vs. 37.9 16.9, difference -6.4 18.7, p 1⁄4 0.049). The exploration and radical resection patients approached with nearly identical baseline QoL (QoL: 61.8 16.9 vs. 62.8 15.6). Patients indicated for BDA (with/without GEA) QoL was significantly higher than in patients indicated for endoscopic stent introduced by (QoL: 54.9 18.8 vs. 30.0 7.1, p <0.001). In all patients, except for the stent group, we observed after 3 months, significant reduction in QoL. Low baseline QoL in patients in whom exploration was performed, was not significantly different from the value of QoL after 3 months. Bleeding, abdominal abscess, biliary or pancreatic fistula or the presence of early infection did not result in significant impairment of QoL after 3 months of treatment. Failure to adjuvant or palliative CHMT has led to significant reductions in QoL in 92 patients after 3 months (QoL: 52.7 20.7 vs. 45.0 20.1, difference -7.7 18.2, p <0.001). CHMT has been made in 59 patients with higher baseline overall QoL scores and led to no significant improvement in QoL (QoL: 52.7 20.7 vs. 56.9 18.3, difference 2.7 16.3, ns.). Conclusions: Basedonprospectivemonitoringof qualityof lifeusing the SF 36/2 the authors reported that 3months after treatment is completed for men, not women, a significant reduction in QoL. 3 months after treatment occurs in patients in stage III and IV significantly reduced QoL, in patients in stage I and II do not. In patients after radical resection, BDA or exploration is significantly reduced postoperative QoL after endoscopic stent placement is not. Complications in the early period after surgery (bleeding, abdominal abscess, biliary, or pancreatic fistula, early infection) do not lead to significant reductions in QoL 3 in comparison with patients without complications. Chemotherapy does not reduce QoL. On the contrary, the absence of adjuvant or palliative chemotherapy leads to significant reduction in QoL observed 3 months after surgery or after initiation. The study results may significantly affect the indication decision to establish the optimal treatment in a patient with pancreatic cancer within a multidisciplinary team, especially when deciding on the type of palliative procedures.