Longitudinal study on quality of life after pancreaticoduodenectomy—a single centre cohort study
Elisabet Forkman, Caroline Williamsson, Bobby Tingstedt, Bodil AnderssonAbstract
Introduction
Pancreaticoduodenectomy (PD) is associated with substantial morbidity. As survival improves, quality of life (QoL) has become an increasingly important outcome. However, long-term QoL outcomes remains poorly characterized, particularly in longitudinal studies. The aim was to evaluate longitudinal trajectories of QoL in patients undergoing PD.
Methods
Patients undergoing PD at Skåne University Hospital between 2012–2019, regardless of diagnosis, were identified. Patient-reported outcomes were prospectively collected using the EORTC QLQ-C30 and PAN26 questionnaires preoperatively, one month postoperatively, and more than 5 years after surgery. Patients alive more than 5 years after PD who responded to the 2024 questionnaire were included.
Results
A total of 70 patients were included, of whom 58 had malignant disease. Among patients with malignancy, approximately half had advanced tumour stage, pT3-pT4 and/or node-positive disease, and adenocarcinoma was the most common diagnosis (n = 54). Clinically relevant deteriorations were observed 1 month after surgery in physical and role functioning, fatigue, appetite loss, digestive symptoms, and taste alterations among some other disease-specific symptoms. Moderate deteriorations were also observed in pain, insomnia, and social functioning, whereas cognitive and emotional functioning remained largely unchanged. At long-term follow-up, most QoL domains had returned to baseline levels or had slightly improved, but satisfaction with healthcare had notably worsened.
Discussion
QoL after PD decreased considerably in the early postoperative period across both general and disease-specific domains. However, these impairments appeared largely reversible over time, even in this cohort with a high proportion of patients with advanced tumour stages.