Quality of life in pancreatic cancer: analysis by stage and treatment

Abstract

In pancreatic cancer patients, survival and palliation of symptoms should be balanced with social and functional impairment, and for this reason, health-related quality of life measurements could play an important role in the decision-making process. The aim of this work was to evaluate the quality of life and survival in 92 patients with different stages of pancreatic adenocarcinoma who underwent surgical and/or medical interventions. Patients were evaluated with the Functional Assessment of Cancer Therapy questionnaires at diagnosis and follow-up (3 and 6 months). At diagnosis, 28 patients (30.5%) had localized disease (group 1) and underwent surgical resection, 34 (37%) had locally advanced (group 2), and 30 (32.5%) metastatic disease (Group 3). Improvement in quality of life was found in group 1, while in group 3, it decreased at follow-up (p=0.03). No changes in quality of life in group 2 were found. Chemotherapy/chemoradiation seems not to significantly modify quality of life in groups 2 and 3. Median survival time for the entire cohort was 9.8 months (range, 1-24). One-year survival was 74%, 30%, and 16% for groups 1, 2, and 3 respectively (p=0.001). Pancreatic cancer prognosis is still dismal. In addition to long-term survival benefits, surgery impacts favorably quality of life.

Figure 1

a Kaplan–Meier overall survival curve in 92 patients with pancreatic cancer. One- and 2-year survival was 39 and 23 months. b Kaplan–Meier survival curves in patients with localized (group 1, n = 28), locally advanced (group 2, n = 34), and metastatic pancreatic cancer (group 3, n = 30) at initial presentation. One-year survival was 74%, 30%, and 16% for groups 1, 2, and 3, respectively (P = 0.001).

Figure 2

Clinical changes in health-related quality of life (HQOL) of patients with local (group 1), locally advanced (group 2), and metastatic (group 3) pancreatic cancer. Square and triangle Meaningful important differences (MID).

Figure 3

Clinical changes in HQOL in patients affected by locally advanced and metastatic pancreatic cancer with or without biliary/enteral stents. Square and triangle Meaningful important differences (MID).

Figure 4

Clinical changes in HQOL of patients with locally advanced and metastatic pancreatic cancer who underwent chemotherapy or chemoradiation. Square Meaningful important differences (MID).

Figure 5

Clinical changes in HQOL of patients with locally advanced and metastatic pancreatic cancer who underwent celiac block or did not. Square, triangle; and circle Meaningful Important Differences (MID).