To investigate quality of life (QOL) trajectories and survival following pancreatic resection for malignant or benign disease.
Consecutive patients undergoing pancreatic resection between Apr-2014 and Apr-2019 at six major hospitals in Sydney, Australia were included. The main outcome was QOL assessed with the Short Form 36 (SF-36v2) and expressed as mental (MCS) and physical component scores (PCS) (/100, 0 worst QOL) and the Functional Assessment of Cancer Therapy – Hepatobiliary (FACT-Hep) (/180, 0 worst QOL). Time from surgery was categorised into 3-11, 12-23, 24-35, and 36-62 months post-surgery for analysis of QOL outcomes. The survival of these patients was analysed using Kaplan-Meier and Log-rank tests.
A total of 278 patients underwent surgery. Mean (SD) age was 65.0 (13.2) years and 51% (n=141) were male. Malignancy was the indication for surgery in 188 patients (68%), of which 169 (61%)underwent pancreaticoduodenectomy. 205 patients were eligible and invited to participate in the QOL study, of which 128 (62%) responded.
No difference in the PCS and total FACT-Hep score was observed for the studied period. A significant improvement in the MCS was observed between 3-11 months and 12-23 months postoperatively (MD: 9.4; 95%CI: 1.1, 17.1) and 3-11 months and 36-62 months (MD: 9.4; 95%CI: 1.1, 17.1).
The median overall survival was 45.8 months (95%CI: 42.4, 49.1). A significant difference in median survival curves was observed according to malignancy 40.3 months (95%CI: 36.4, 44.2), premalignancy 54.3 months (95%CI: 47.5, 61.0), and benign disease 41.3 months (95%CI: 37.9, 44.9).
MCS improved significantly between 3-11 months and 12-23 months and 3-11 months and 36-62 months, with no further significant changes in QOL outcomes observed. A significant difference in median survival curves was observed for malignant, premalignant, and benign disease.