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QUALITY OF LIFE AND SOCIAL HEALTH IN PATIENTS AFTER PANCREATIC SURGERY
Nicholas Galouzis
*, Maria K. Fotinos, Evelyn V. Alexander, Mohammad Khreiss, Carrie Luu, Lusine Mesropyan, Taylor S. Riall
Department of Surgery, Banner - University Medical Center Tucson, Tucson, AZ
Introduction: When helping patients make decisions about pancreatic surgery, clinicians lack robust data on quality of life and social functioning to help patients make decisions aligned with their goals of care. Our aim was to assess quality of life (QOL) and social health in patients who underwent pancreatectomy for benign and malignant disease.
Methods: We administered the: 1) European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30); 2) pancreas specific QLQ-PAN26; 3) Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles Activities; 4) PROMIS Social Isolation scales to all patients who underwent elective pancreatic surgery at our institution between 2021-2023. For all surveys, a score of 100 is the highest score and indicates the maximum QOL. EORTC QLQ-C30 and the social health PROMIS questionnaires were compared to normative data of the general population from the United States.
Results: 143 patients were included in this study with 71 (49.6%) completing the distributed surveys. Demographics, pathology, and major complication rates were similar between responders and non-responders. The average age of responders was 59.9±16.1 years. 56.3% were male. Distal pancreatectomy was performed in 40.8%, pancreaticoduodenectomy in 55.0% and total pancreatectomy in 4.2%. Indications for surgery were pancreatic cancer (24.5%), other malignancies (45.5%), and benign disease (30.0%). Compared to normative population controls, post-pancreatectomy patients had higher global health (72.7±22.9 vs 63.9±22.9, p<0.01) and physical functioning scores (85.6±17.2 vs 80.8±25.2 p=0.03). However, their social health was significantly impacted by surgery. Their QLQ-C30 role functioning (67.2±28.7 vs 81.7±28.2, p<0.01), PROMIS ability to participate in social roles and activities (39.4±10.0 vs 50.0±10.0, p<0.01), and PROMIS social isolation scores (38.6±8.9 vs 50.0±10.0, p<0.01) were all significantly lower in pancreatectomy patients compared to general population data. Patients who underwent a pancreatectomy for benign disease were more likely to have a worse QOL in their ability to participate in social roles and activities (35.1±7.6 vs 41.3±10.4, p=0.02) and social isolation (35.1±7.6 vs 40.0±9.1, p=0.03) scales. Time from surgery and major postoperative complications were not associated with better or worse QOL in domains analyzed.
Conclusions: While patients undergoing pancreatectomy report overall good global health and physical functioning, pancreatectomy negatively impacts their desired social role functioning, ability to participate in social activities, and feelings of social isolation. These issues are largely unaddressed by surgeons and oncologists and are potential targets for intervention in improving QOL.
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