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PATIENT-REPORTED OUTCOMES AT THREE MONTHS AFTER PANCREATIC SURGERY FOR BENIGN AND MALIGNANT DISEASES
Meike ten Winkel*1, Hussein Salama2, Kai Timrott3, Moritz Kleine3,4, Dennis Kleine-Doepke3, Stephanie Raehder-Johnson5, Holger Meisel5, Nuh N. Rahberi6, Schaima Abdelhadi6, Felix Rückert6,7, Christoph Reissfelder6, Kim C. Honselmann1, Rüdiger Braun1, Benedikt Faerber1, Hryhoriy Lapshyn1, Tobias Keck1, Ulrich F. Wellner1, Louisa Bolm1
1Klinik für Chirurgie, Universitatsklinikum Schleswig Holstein Campus Lubeck, Lubeck, Schleswig-Holstein, Germany; 2Ruhr-Universitat Bochum, Bochum, Nordrhein-Westfalen, Germany; 3Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany; 4Vinzenzkrankenhaus Hannover gGmbH, Hannover, Niedersachsen, Germany; 5Krankenhaus Winsen, Winsen, Schleswig-Holstein, Germany; 6Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany; 7Diakonissen Speyer-Mannheim, Speyer, Rheinland-Pfalz, Germany

Background: Pancreatic surgery involves complex operative procedures and may have a long-lasting effect on patients' health status and quality of life. Large-scale studies on patient-reported outcomes in patients after pancreatic procedures are warranted.

Methods: Patients scheduled for pancreatic surgery were enrolled in a prospective trial at five German centers of pancreatic surgery. Patients completed standardized validated patient-reported outcomes questionnaires (EQ-5D-5L, EORTC QLQ-PAN26, patient reported happiness, and HADS-D), and we report on the first follow-up three months after surgery. Statistical testing was performed with Chi-Square test, t-test, Kruskal-Wallis Test and Wilcoxon Matched Pairs Test using the R software.

Results: In the time period from 2019-2022 203 patients were enrolled, and a three-month follow-up questionnaire was available in 135 (65.5%) patients. Mean age was 65.2 years and 59 (44.4%) of the patients were female. 77 (57.9%) of the patients underwent surgery for a malignant tumor. Patient-reported health status (EQ-5D-5L) was impaired in four out of five dimensions (mobility, self-care, usual activities, pain, discomfort) for patients with malignant and three out of five dimensions (mobility, self-care, usual activities) for patients with benign disease three months after surgery as compared to before (p<0.05). Patients with malignant disease reported an increase in depressive symptoms, while patients with benign disease had a decrease in anxiety symptoms (HADS-D; depression: 5.00 vs 6.51, p=0.002; anxiety: 8.04 vs. 6.34, p=0.030). Regarding pancreatic-disease-specific symptoms (EORTC-PAN26), patients with malignant disease reported increased problems with taste, weight loss, weakness in arms and legs, dry mouth, body image and troubling side effects at three months. Patients with benign disease indicated more weakness in arms and legs, troubling side effects but less future worries at three months.

Discussion: Patient-reported outcomes of patients undergoing pancreatic surgery for benign as compared to malignant disease show important differences. While both patient groups report impairments in various dimensions at 3 months after surgery, patients with malignant tumors report more severely decreased quality of life three months postoperatively than patients with benign tumors.
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