Highlights
- •Quality of life predicted survival of pancreatic ductal adenocarcinoma patients.
- •Lower quality of life found in Hispanic patients compared with non-Hispanic whites.
- •Tumour stage had the most impact on physical quality of life.
- •Other determinants were sex, age, education, smoking, drinking, comorbidities, and time since diagnosis.
- •Determinants of quality of life were similar among different racial groups.
Abstract
Background
Quality of life (QOL) is impaired in pancreatic cancer patients. Our aim was to investigate
the determinants and prognostic value of QOL after diagnosis in a hospital-based cohort
of racially/ethnically diverse patients with pancreatic ductal adenocarcinoma (PDAC).
Patients and methods
QOL was prospectively assessed using the Short Form-12 in 2478 PDAC patients. The
Physical Component Summary (PCS) and Mental Component Summary (MCS) were categorised
into tertiles based on their distribution. Ordered logistic regression was adopted
to compare the risk of having lower PCS and MCS by patient sociodemographic and clinical
characteristics. The association of PCS and MCS with mortality was assessed by Cox
regression.
Results
Compared with non-Hispanic whites, Hispanics were at significantly higher risk of
having lower PCS (odds ratio [95% CI], 1.69 [1.26–2.26]; P < 0.001) and lower MCS (1.66 [1.24–2.23]; P < 0.001). Patients diagnosed with stage III (1.80 [1.10–2.94]; P = 0.02) and stage IV (2.32 [1.50–3.59]; P < 0.001) PDAC were more likely to have lower PCS than stage I patients. Other determinants
of QOL included sex, age, drinking, smoking, education level, comorbidities and time
since diagnosis. The low tertile of PCS (hazard ratio [95% CI], 1.94 [1.72–2.18];
P < 0.001) and MCS (1.42 [1.26–1.59]; P < 0.001) were each related to poor prognosis. Similar results were found for non-Hispanic
whites as compared with African-Americans/Hispanics/others.
Conclusion
QOL after diagnosis is a significant prognostic indicator for patients with PDAC.
Multiple factors determine QOL, suggesting possible means of intervention to improve
QOL and outcomes of PDAC patients.
Keywords
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Article info
Publication history
Published online: February 01, 2018
Accepted:
December 20,
2017
Received in revised form:
December 13,
2017
Received:
August 10,
2017
Identification
Copyright
© 2017 Published by Elsevier Ltd.
