A qualitative study of patient and clinician attitudes regarding surveillance after a resection of pancreatic and periampullary cancer

Deobald, Raymond G.; Cheng, Emily YiQin; Ko, Yoo‐Joung; Wright, Frances C.; Karanicolas, Paul J.

doi:10.1111/hpb.12378

Cited by 27 publications

(27 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Probable relapse should not deter nor delay provision of survivorship care, but instead, offer an opportunity to improve survivorship support. Many pancreatic cancer patients convey a limited understanding of their prognosis while clinicians believe patients are aware of their recurrence risk (4). SCPs, if appropriately articulated, could stand to improve communication between physicians and patients regarding prognosis while still providing hope.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Survivorship after Treatment of Pancreatic Cancer: Insights Via an Internet-Based Survivorship Care Plan Tool

Frick

Vachani

Hampshire

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…Little dialogue or investigation has been committed to this topic in pancreatic cancer, perhaps to the detriment of the patient. A lack of supporting evidence devoted to surveillance practices in pancreatic cancer has led to heterogeneity in follow-up and disagreement on its necessity and efficacy (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Survivorship after Treatment of Pancreatic Cancer: Insights Via an Internet-Based Survivorship Care Plan Tool

Frick

Vachani

Hampshire

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

“…In recent years, cancer survivors, patient organizations representing a range of organ-specific cancers, as well as the Danish Health and Medicines Authority have advocated that follow-up should include a broader rehabilitative focus on patients' individual needs, concerns and life-situation [1]. One reason for this is that although patients gain temporary reassurance through regular follow-up, follow-up focusing mainly on disease relapse may paradoxically increase fear and anxiety and impact negatively on uptake of everyday life [5]. Patients with pancreatic, duodenal or bile duct cancers may for example suffer from treatment-related sequelae such as fatigue, nausea, pain, exocrine and endocrine dysfunction and cognitive problems [6][7][8], all symptoms potentially influencing rehabilitation and quality of life (QOL) if not adequately addressed by health care professionals (HCPs) [9].…”

Section: Original Articlementioning

confidence: 99%

“…Qualitative investigation of the patient perspective may provide valuable insight into how patients experience follow-up, their expectations and how they perceive HCPs address their needs [10]. To our knowledge, only one study has investigated patients' and HCPs' attitudes toward surveillance after curatively intended surgical resection of pancreatic cancer [5]. This study found that patients felt reassured by frequent follow-up visits, they wanted to be informed about recurrence, and attending follow-up was 'like a walk in the park', notably as long as everything was fine [5].…”

Section: Original Articlementioning

confidence: 99%

“…To our knowledge, only one study has investigated patients' and HCPs' attitudes toward surveillance after curatively intended surgical resection of pancreatic cancer [5]. This study found that patients felt reassured by frequent follow-up visits, they wanted to be informed about recurrence, and attending follow-up was 'like a walk in the park', notably as long as everything was fine [5]. Interestingly, patients' and HCPs' expectations regarding prognosis differed with patients being much more optimistic than HCPs.…”

Section: Original Articlementioning

confidence: 99%

See 1 more Smart Citation

It’s all about the CA-19-9. A longitudinal qualitative study of patients’ experiences and perspectives on follow-up after curative surgery for cancer in the pancreas, duodenum or bile-duct

et al. 2019

View full text Add to dashboard Cite

Background: Patients undergoing curative surgery for cancers of the pancreas, duodenum or bile ducts currently attend follow-up at specialized centers. Traditionally, follow-up after cancer has focused on cancer relapse. The Danish Health and Medicines Authority has recently pushed for a wider focus incorporating patients' individual needs and concerns during cancer rehabilitation. We aimed to explore patients' experiences of and perspectives on the rehabilitative scope of the current follow-up within the first year after curative treatment. Material and methods: A qualitative longitudinal design was undertaken with individual semi-structured interviews. We included twelve patients attending current follow-up after treatment for cancer in the pancreas, duodenum or bile-duct. We interviewed the patients three times over a period of 9 months. Data were analyzed longitudinally using inductive content analysis. Results: The patients experienced the cancer antigen (CA-19-9) as the center piece of follow-up, with consultations revolving largely around the CA-19-9 results. Parallel to and independent of follow-up, the patients described an array of creative strategies for adapting to their altered bodies and new life situation. The strategies included homemade endeavors to minimize gut symptoms, for example mint tablets or dairy products without lactose: realizing lifelong dreams and resolving financial matters; confiding with likeminded outside the family or professionals outside the hospital. First encounters with HCPs were critically important with bad first encounters haunting patients throughout follow-up and good first encounters facilitating trust and reciprocity between patients and HCPs. Conclusion: Patients in this study perceived detection of relapse through CA-19-9 as the focal point of follow-up, leaving other patient-important symptoms insufficiently addressed. We may, therefore, consider not using this relatively unprecise marker for relapse in the future. Balancing clinicians' needs to diagnose relapse with patients' needs for rehabilitation warrants attention in clinical practice and future research.

show abstract

Routine Imaging or Symptomatic Follow-Up After Resection of Pancreatic Adenocarcinoma

Andel,

van Goor,

Augustinus

et al. 2024

JAMA Surg

View full text Add to dashboard Cite

ImportanceInternational guidelines lack consistency in their recommendations regarding routine imaging in the follow-up after pancreatic resection for pancreatic ductal adenocarcinoma (PDAC). Consequently, follow-up strategies differ between centers worldwide.ObjectiveTo compare clinical outcomes, including recurrence-focused treatment and survival, in patients with PDAC recurrence who received symptomatic follow-up or routine imaging after pancreatic resection in international centers affiliated with the European-African Hepato-Pancreato-Biliary Association (E-AHPBA).Design, Setting, and ParticipantsThis was a prospective, international, cross-sectional study. Patients from a total of 33 E-AHPBA centers from 13 countries were included between 2020 and 2021. According to the predefined study protocol, patients who underwent PDAC resection and were diagnosed with disease recurrence were prospectively included. Patients were stratified according to postoperative follow-up strategy: symptomatic follow-up (ie, without routine imaging) or routine imaging.ExposuresSymptomatic follow-up or routine imaging in patients who underwent PDAC resection.Main Outcomes and MeasuresOverall survival (OS) was estimated with Kaplan-Meier curves and compared using the log-rank test. To adjust for potential confounders, multivariable logistic regression was used to evaluate the association between follow-up strategy and recurrence-focused treatment. Multivariable Cox proportional hazard analysis was used to study the independent association between follow-up strategy and OS.ResultsOverall, 333 patients (mean [SD] age, 65 [11] years; 184 male [55%]) with PDAC recurrence were included. Median (IQR) follow-up at time of analysis 2 years after inclusion of the last patient was 40 (30-58) months. Of the total cohort, 98 patients (29%) received symptomatic follow-up, and 235 patients (71%) received routine imaging. OS was 23 months (95% CI, 19-29 months) vs 28 months (95% CI, 24-30 months) in the groups who received symptomatic follow-up vs routine imaging, respectively (P = .01). Routine imaging was associated with receiving recurrence-focused treatment (adjusted odds ratio, 2.57; 95% CI, 1.22-5.41; P = .01) and prolonged OS (adjusted hazard ratio, 0.75; 95% CI, 0.56-.99; P = .04).Conclusion and RelevanceIn this international, prospective, cross-sectional study, routine follow-up imaging after pancreatic resection for PDAC was independently associated with receiving recurrence-focused treatment and prolonged OS.

show abstract

A qualitative study of patient and clinician attitudes regarding surveillance after a resection of pancreatic and periampullary cancer

Cited by 27 publications

References 42 publications

Survivorship after Treatment of Pancreatic Cancer: Insights Via an Internet-Based Survivorship Care Plan Tool

Survivorship after Treatment of Pancreatic Cancer: Insights Via an Internet-Based Survivorship Care Plan Tool

It’s all about the CA-19-9. A longitudinal qualitative study of patients’ experiences and perspectives on follow-up after curative surgery for cancer in the pancreas, duodenum or bile-duct

Routine Imaging or Symptomatic Follow-Up After Resection of Pancreatic Adenocarcinoma

Contact Info

Product

Resources

About