A prospective longitudinal study of the impact of pancreatic resection for malignancy on health related quality of life

Aims: Health-related quality of life (QoL) is of high importance in pancreatic cancer, due to the limited life expectation. The aim of this prospective longitudinal study was to describe QoL in patients undergoing resection for pancreatic or periampullary malignancy. Methods: Prospective longitudinal cohort study in a tertiary HPB referral center. We included patients who underwent pancreatic resection for pancreatic or peri-ampullary malignancy or pre-malignancy. QoL was measured before resection and 1, 3, 6, and 12 months postoperatively. Measures consisted of the RAND-36, the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (QLQ-C30) and the EORTC pancreatic cancer-specific module (QLQ-PAN26). Results: Between March 2012 and November 2013, 68 consecutive patients with a malignancy (n=59) or pre-malignancy (n=9) were included. Most physical, social and emotional domains showed a statistically significant and clinically relevant deterioration directly after operation. Most domains demonstrated preoperative values or better at 3 months, except for ‘physical functioning’. Emotional functioning at 3, 6, and 12 months was statistically significant better compared to baseline. Symptom scores revealed a deterioration of ‘vitality’, ‘pain’, ‘fatigue’, ‘appetite loss’, ‘altered bowel habit’ and ‘side effects’ after one month. After three months, only ‘side effects’ were worse compared to preoperative values. Conclusions: QoL after pancreatic resection for malignant and premalignant tumors decreases considerably. Full recovery of QoL takes up to 6 months after the operation.