Impairment of perioperative activities of daily living is associated with poor prognosis following pancreatectomy for pancreatic cancer

Abstract

Purpose The number of patients with pancreatic cancer coping with impaired activities of daily living (ADLs) is continually increasing. This study aimed to examine the association between perioperative Barthel Index (BI) scores, a validated measure of ADLs, and survival outcomes after pancreatectomy for pancreatic cancer. Methods We analyzed the data of 201 patients who underwent pancreatectomy for pancreatic cancer between 2010 and 2020. Preoperative and postoperative ADLs were assessed using the BI (range: 0–100; higher scores indicated greater independence). A preoperative or postoperative BI score ≤ 85 was defined as an impairment of perioperative ADLs. Cox proportional hazards regression was used to calculate the hazard ratios (HRs) after adjusting for potential confounders. Results Among the 201 patients, 14 (7.0%) had a preoperative BI score ≤ 85 and 50 (25%) had a postoperative BI score ≤ 85. Impairment of perioperative ADLs was independently associated with shorter overall survival (multivariable HR: 1.91, 95% confidence interval [95%CI]: 1.04–3.49, P = 0.036), cancer-specific survival (multivariable HR: 1.97, 95%CI: 1.15–3.38, P = 0.013), and recurrence-free survival (multivariable HR: 1.94, 95%CI: 1.08–3.50, P = 0.021). Conclusion Impairment of perioperative ADLs is associated with poor prognosis following pancreatectomy for pancreatic cancer. The maintenance and improvement of perioperative ADLs could play an important role in providing favorable long-term outcomes in patients with pancreatic cancer.