The prognostic factors and trajectory of HRQOL in patients with pancreatic cancer who received psychiatric intervention

Hiroyuki Sugimoto, Hiroki Kawashima, Eizaburo Ohno, Daijuro Hayashi, Takamichi Kuwahara, Tomomasa Morishima, Manabu Kawai, Hiroki Suhara, Tomoaki Takeyama, Takeshi Yamamura, Kohei Funasaka, Masanao Nakamura, Ryoji Miyahara, Osamu Watanabe, Masatoshi Ishigami, Miho Suzuki, Hiroyuki Kimura, Norio Ozaki, Senju Hashimoto, Hidemi GotoYoshiki Hirooka

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background and Aim: Patients with advanced pancreatic cancer have severe pain, anxiety, and depression, and these symptoms deteriorate quality of life (QOL). Previous study reported that early psychiatric intervention for advanced cancer patients may improve QOL. We evaluated the trajectory of health-related QOL (HRQOL) in patients with pancreatic cancer after an early psychiatric intervention. Methods: A prospective cohort study was performed in 108 pancreatic cancer patients who received consultation liaison psychiatry from November, 2011 to October, 2014 at Nagoya University Hospital. Longitudinal changes in HRQOL and the association between aspects of HRQOL and survival were evaluated using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 before treatment and every month after the start of treatment. Results: Physical functioning significantly decreased after 1, 3, and 6months of treatment compared with baseline, but global health status (GHS), role functioning, emotional functioning, and social functioning showed a tendency to improve. Severe impairment of GHS, fatigue, and appetite loss were apparent at 3months prior to death. In multivariate analysis, pain was a significant prognostic factor for survival (hazard ratio [HR], 1.109; 95% confidence interval [CI], 1.021-1.204; P=0.013), in addition to poor performance status (HR, 5.473; 95%CI, 2.338-12.816; P < .0001) and distant metastases at diagnosis (HR, 3.274; 95%CI, 1.872-5.725; P < .0001). Conclusions: Early psychiatric intervention in patients with pancreatic cancer may maintain HRQOL. More effective pain management and reduction of psychological distress are important for patients with pancreatic cancer.

Original languageEnglish
Pages (from-to)685-690
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume31
Issue number3
DOIs
Publication statusPublished - 01-03-2016

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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