Quality-of-Life After Total Pancreatectomy: Is It Really That Bad on Long-term Follow-up?

Billings, Brian J.; Christein, John D.; Harmsen, William S.; Harrington, Jeffrey R.; Chari, Suresh T.; Que, Florencia G.; Farnell, Michael B.; Nagorney, David M.; Sarr, Michael G.

doi:10.1016/j.gassur.2005.05.014

Cited by 173 publications

(166 citation statements)

References 27 publications

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“…17 Health-related quality of life (HQOL) seeks to measure the impact of disease process on physical, psychological, and social aspects of the person's life and feeling of well-being, [18][19][20] and recently, has become an important subject in pancreatic cancer care, with the aim of measuring the impact of different interventions on patients' health and life. 18,[21][22][23][24] It has become clear that in a disease-like pancreatic cancer, in which patients have a short life expectancy, improvements in survival and treatment-related complications must be carefully balanced against HQOL outcomes to define better approaches while considering patients' personal needs.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life in Pancreatic Cancer: Analysis by Stage and Treatment

Crippa

Domínguez

Rodríguez

et al. 2008

Journal of Gastrointestinal Surgery

104

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In pancreatic cancer patients, survival and palliation of symptoms should be balanced with social and functional impairment, and for this reason, health-related quality of life measurements could play an important role in the decision-making process. The aim of this work was to evaluate the quality of life and survival in 92 patients with different stages of pancreatic adenocarcinoma who underwent surgical and/or medical interventions. Patients were evaluated with the Functional Assessment of Cancer Therapy questionnaires at diagnosis and follow-up (3 and 6 months). At diagnosis, 28 patients (30.5%) had localized disease (group 1) and underwent surgical resection, 34 (37%) had locally advanced (group 2), and 30 (32.5%) metastatic disease (Group 3). NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptImprovement in quality of life was found in group 1, while in group 3, it decreased at follow-up (p = 0.03). No changes in quality of life in group 2 were found. Chemotherapy/chemoradiation seems not to significantly modify quality of life in groups 2 and 3. Median survival time for the entire cohort was 9.8 months (range, 1-24). One-year survival was 74%, 30%, and 16% for groups 1, 2, and 3 respectively (p = 0.001). Pancreatic cancer prognosis is still dismal. In addition to long-term survival benefits, surgery impacts favorably quality of life.

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Section: Introductionmentioning

confidence: 99%

Quality of Life in Pancreatic Cancer: Analysis by Stage and Treatment

Crippa

Domínguez

Rodríguez

et al. 2008

Journal of Gastrointestinal Surgery

104

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“…Moreover, pancreatic enzyme replacement therapy has improved GI symptoms and largely resolved nutritional deficiency in appropriately managed patients [38,45] . As a result, post-TP QoL is now reported to be comparable to that of regular type 1 diabetics, post-PD patients and even the age-matched general population [44,[46][47][48][49] .…”

Section: Discussion: Who Should Undergo Tp For Ipmn?mentioning

confidence: 83%

Is It Time to Expand the Role of Total Pancreatectomy for IPMN?

Griffin

Poruk

Wolfgang³

2016

Dig Surg

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Intraductal papillary mucinous neoplasms (IPMN) are cystic precursors to pancreatic cancer believed to arise within a widespread neoplastic field defect. The tendency for some patients to present with multifocal disease and/or develop additional lesions over time argues in favor of a field defect and complicates surgical management decisions. Surgery usually consists of partial pancreatic resection, which leaves behind a pancreatic remnant at risk for recurrent disease and progression to cancer. As an alternative, total pancreatectomy (TP) provides the most complete oncologic resection, but postoperative morbidity and quality of life (QoL) issues have generally limited its use to only the highest risk patients. Significant progress has been made in the management of the post-TP apancreatic state and studies now show less morbidity with acceptable QoL comparable to type 1 diabetic and post-pancreaticoduodenectomy patients. These improvements do not yet justify the routine use of TP, but they have opened the door for expansion to additional subsets of non-invasive IPMN. Here, we have identified several groups of patients that we believe would benefit from TP over partial resection based on the most current literature.

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“…The main criterion for success of the islet autograft per se is whether insulin independence is maintained or surgical diabetes made milder. The overall outcome, however, depends as much on the clinical response as on the metabolic results, specifically whether the patient's pain is reduced or eliminated, narcotic analgesics withdrawn, and the quality of life (QOL) improved (Bellin et al, 2010b;Bellin et al, 2011b;Bellin et al, 2011c;Billings et al, 2011;Rafael et al, 2008;Sutton et al, 2010).…”

Section: Wwwintechopencommentioning

confidence: 99%