title: Quality of life and functional outcome after resection of pancreatic cystic neoplasm.
abstract: OBJECTIVE
  The objectives of this study were to assess the long-term quality of life (QOL) after the resection of a primary pancreatic cyst and to determine predictors of outcome. Secondary outcomes were pancreatic function and survival.
  
  
  METHODS
  One hundred eight consecutive patients, who underwent resection between 1992 and 2007 and had nearly 60 months follow-up, were reviewed. Questionnaires and function tests were collected during scheduled outpatient clinic visits.
  
  
  RESULTS
  At follow-up, 20 patients had died. Five-year overall survival was 94% for benign and 62% for malignant neoplasia. Of 88 living patients, 65 (74%) returned questionnaires. Generic physical and mental QOL scores were equal or better compared with healthy references. None of the disease-specific symptom scales were above mean 50, implicating none to mild complaints. Independent predictors for good generic QOL were young age (P < 0.05) and resected malignancy (P < 0.05); predictors for good gastrointestinal QOL were male sex (P < 0.1), limited resection (P < 0.05), endocrine insufficiency (P < 0.05), and employment (P < 0.05). Endocrine insufficiency prevalence was 40%, and 59% for exocrine insufficiency.
  
  
  CONCLUSIONS
  After cyst resection, long-term QOL is equal to healthy references, pancreatic insufficiency is prevalent but does not impair QOL, and survival relates positive compared with solid pancreatic adenocarcinoma. The excellent long-term outcome justifies proceeding with surgery once a medical indication for resection has been established.
authors.affiliation: From the Departments of *Surgery, †Medical Psychology, and ‡Gastroenterology, Academic Medical Center, Amsterdam; and §Department of Gastroenterology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Niels A
authors.initials: NA
authors.lastname: van der Gaag
authors.forename: Olvert A
authors.initials: OA
authors.lastname: Berkhemer
authors.forename: Mirjam A
authors.initials: MA
authors.lastname: Sprangers
authors.forename: Olivier R C
authors.initials: OR
authors.lastname: Busch
authors.forename: Marco J
authors.initials: MJ
authors.lastname: Bruno
authors.forename: Steve M
authors.initials: SM
authors.lastname: de Castro
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Gouma
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010179:Pancreas / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D010181:Pancreatic Cyst / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome