Back to Program | 2010 Program and Abstracts Overview | 2010 Posters

Background: In is common to use quality of life (QoL) measures to assess treatment outcomes for pancreatic disease. However, in other disease processes, it has been suggested that pretreatment QoL scores can predict the outcome of treatment; specifically, in some malignant diseases, QoL can predict survival. This study assessed whether pre-treatment QoL scores could predict malignancy in patients with pancreatic lesions and survival in those with malignancies.Methods: Patients for surgery with pancreatic lesions completed the SF-36, which contains 8 domains measuring QoL: physical functioning (PF), role-physical (RP), role-emotional (RE), bodily pain (BP), vitality (VT), mental health (MH), social functioning (SF), and general health (GH). Best possible score is 100, worst possible score is 0. Patients with pain related to known chronic pancreatitis were excluded from the study; however, undiagnosed solid or cystic lesions were included. Data obtained included age, gender, resectability, additional antineoplastic therapy, stage, pathology, and survival. Patients were categorizes by pathology (benign vs. malignant), stage (local, regional or distant), resectability (resected vs. not), survival (<1 yr. vs. >1yr.) and their pretreatment QoL scores. Data were analyzed by the Mann-Whitney U-test, Cox’s Proportional Hazards model, and multiple logistic regression analysis.Results: Of the 323 patients assessed, 210 had malignancies. In 6 of the 8 domains, patients with malignancies had lower median QoL scores compared to patients with benign lesions: PF 60 vs 85 (p=0.0003), RP 0 vs 75 (p=0.005), RE 100 vs 100 (p=0.004), VT 45 vs 55 (p=0.0002), SF 62.5 vs 87.5 (p=0.0007) and GH 62 vs 72 (p=0.03). Of the patients with malignancies, patients surviving <1 yr, had lower pretreatment scores in all domains (PF 30 vs 70, RP 0 vs 75, RE 0 vs 100, BP 41 vs 74, VT 20 vs 50, MH 60 vs 80, SF 50 vs 87.5, and GH 55 vs 70, all p<0.008). Stage, resection, adjuvant therapy, and VT score were independent predictors of survival.Conclusions: Patients with pancreatic malignancies had lower QoL scores than patients with benign pancreatic disease. Patients with malignancies surviving <1 yr. had lower scores, even after controlling for stage. These lower scores may reflect more advanced disease or frailties which identify patients with poor prognoses. This suggests that pretreatment QoL scores may be used to predict which patients will have a poor survival and therefore could avoid aggressive, but futile, treatment.