Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar;18(3):247-54.
doi: 10.1016/j.hpb.2015.09.004. Epub 2015 Nov 19.

Preoperative cognitive function predicts survival in patients with resectable pancreatic ductal adenocarcinoma

Bart M G Baekelandt  1 , Marianne J Hjermstad  2 , Tom Nordby  3 , Morten W Fagerland  4 , Elin H Kure  5 , Turid Heiberg  6 , Trond Buanes  7 , Knut J Labori  8
Affiliations

Preoperative cognitive function predicts survival in patients with resectable pancreatic ductal adenocarcinoma

Bart M G Baekelandt et al. HPB (Oxford). 2016 Mar.

Abstract

Background: The purpose of this prospective study was to evaluate whether pre-surgery health-related quality of life (HRQoL) and subjectively rated symptom scores are prognostic factors for survival in patients with resectable pancreatic ductal adenocarcinoma (PDAC).

Methods: Patients undergoing pancreatic resection for PDAC completed the Edmonton Symptom Assessment System (ESAS) and the EORTC QLQ-C30 and QLQ-PAN26 questionnaires preoperatively. Patient, tumor and treatment characteristics, recurrence and survival were registered.

Results: Sixty-six consecutive patients underwent R0/R1 resection for PDAC. Baseline ESAS and EORTC questionnaire compliance was 44/66 (67%) with no statistically significant differences between compliers (n = 44) and non-compliers (n = 22) when comparing clinicopathological parameters and survival. Univariable analyses showed that three symptoms (nausea, dry mouth, cognitive function) and two clinicopathological factors (CA 19-9 > 400 U/ml, lymph node ratio > 0.1) were significantly associated with shorter survival (p < 0.05). In multivariable analysis, cognitive function was the only independent predictor for survival: hazard ratio = 0.35 (95%CI 0.13-0.93) for high vs low cognitive function. Median survival times for patients with high and low cognitive function were 21 and 10 months, respectively (p < 0.001).

Conclusion: Presurgery cognitive function is a significant independent predictor of survival in patients with resectable PDAC. Thus, presurgery patient reported outcomes may provide as strong prognostic information as clinicopathological factors.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(a) Kaplan-Meier estimate for disease-free (recurrence-free) and overall survival for all 44 patients with complete HRQoL data. (b) Kaplan-Meier estimate for disease-free survival for high and low cognitive function scores. (c) Kaplan-Meier estimate for overall survival for high and low cognitive function scores
See this image and copyright information in PMC

References

    1. Malvezzi M., Bertuccio P., Levi F., La Vecchia C., Negri E. European cancer mortality predictions for the year 2014. Ann Oncol. 2014;25:1650–1656. - PubMed
    1. Siegel R., Ma J., Zou Z., Jemal A. Cancer statistics. CA Cancer J Clin. 2014;64:9–29. - PubMed
    1. Gillen S., Schuster T., Meyer Zum Buschenfelde C., Friess H., Kleeff J. Preoperative/neoadjuvant therapy in pancreatic cancer: a systematic review and meta-analysis of response and resection percentages. PLoS Med. 2010;7:e1000267. - PMC - PubMed
    1. He J., Ahuja N., Makary M.A., Cameron J.L., Eckhauser F.E., Choti M.A. 2564 resected periampullary adenocarcinomas at a single institution: trends over three decades. HPB. 2014;16:83–90. - PMC - PubMed
    1. Hartwig W., Hackert T., Hinz U., Gluth A., Bergmann F., Strobel O. Pancreatic cancer surgery in the new millennium: better prediction of outcome. Ann Surg. 2011;254:311–319. - PubMed

MeSH terms