title: Quality of life in patients with pancreatic ductal adenocarcinoma undergoing pancreaticoduodenectomy.
abstract: BACKGROUND
  Survival for pancreatic ductal adenocarcinoma (PDAC) is relatively short even after complete resection. Pancreaticoduodenectomy (PD) carries a high risk for postoperative morbidity, and the effect on quality of life (QoL) is unclear. We aimed to study QoL in PDAC patients undergoing PD.
  
  
  METHODS
  Sixty patients with suspected PDAC and planned PD were asked to complete EORTC QoL questionnaires QLQ-C30 and QLQ-PAN26 preoperatively and at 3-6-12-18-24 months postoperatively.
  
  
  RESULTS
  47 PDAC patients who underwent PD (66 (21-84) years, 53% men) were included. Follow-up was completed by 81% (6 months) and 45% (24 months) post-PD. Compared to preoperative level, QoL tended to improve or remained the same in 63% during the follow-up. At three months after PD patients had less hepatic symptoms (decreased by 100%; p < 0.001), pancreatic pain and sexuality symptoms tended to decrease by 33% and global and functional QoL tended to slightly improve. These parameters remained at the achieved level during the longer follow-up. A temporary rising tendency was seen in digestive symptoms at three months but this later reverted to the preoperative level. More altered bowel movements and sexuality symptoms tended to arise during the longer follow-up. A negative correlation was found between reported financial difficulties and length of survival.
  
  
  CONCLUSIONS
  PD does not worsen the QoL in most of the patients with PDAC. The potentially beneficial effect on QoL is apparent already at three months after surgery. This information may be helpful for the clinician and patient, when deciding on the treatment for PDAC.
authors.affiliation: Dept of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Ismo
authors.initials: I
authors.lastname: Laitinen
authors.affiliation: Dept of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Sand
authors.affiliation: Dept of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Pipsa
authors.initials: P
authors.lastname: Peromaa
authors.affiliation: Dept of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Isto
authors.initials: I
authors.lastname: Nordback
authors.affiliation: Dept of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. Electronic address: johanna.laukkarinen@fimnet.fi.
authors.forename: Johanna
authors.initials: J
authors.lastname: Laukkarinen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D003071:Cognition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D012919:Social Behavior; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Pancreatic cancer; Pancreaticoduodenectomy; Quality of life