Determinants and prognostic value of quality of life in patients with pancreatic ductal adenocarcinoma

Yang Deng, Huakang Tu, Jeanne A. Pierzynski, Ethan D. Miller, Xiangjun Gu, Maosheng Huang, David W. Chang, Yuanqing Ye, Michelle A.T. Hildebrandt, Alison Klein, Ren Zhao, Scott M. Lippman, Xifeng Wu

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)20-32
Number of pages13
JournalEuropean Journal of Cancer
Volume92
DOIs
StatePublished - Mar 1 2018

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Value of Life
Adenocarcinoma
Quality of Life
Hispanic Americans
Pancreatic Neoplasms
African Americans
Drinking
Comorbidity
Logistic Models
Smoking
Odds Ratio
Education

Keywords

  • Overall survival
  • Pancreatic ductal adenocarcinoma
  • Prognostic indicator
  • Quality of life
  • Short Form-12

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Determinants and prognostic value of quality of life in patients with pancreatic ductal adenocarcinoma. / Deng, Yang; Tu, Huakang; Pierzynski, Jeanne A.; Miller, Ethan D.; Gu, Xiangjun; Huang, Maosheng; Chang, David W.; Ye, Yuanqing; Hildebrandt, Michelle A.T.; Klein, Alison; Zhao, Ren; Lippman, Scott M.; Wu, Xifeng.

In: European Journal of Cancer, Vol. 92, 01.03.2018, p. 20-32.

Research output: Contribution to journalArticle

Deng, Y, Tu, H, Pierzynski, JA, Miller, ED, Gu, X, Huang, M, Chang, DW, Ye, Y, Hildebrandt, MAT, Klein, A, Zhao, R, Lippman, SM & Wu, X 2018, 'Determinants and prognostic value of quality of life in patients with pancreatic ductal adenocarcinoma', European Journal of Cancer, vol. 92, pp. 20-32. https://doi.org/10.1016/j.ejca.2017.12.023
Deng, Yang ; Tu, Huakang ; Pierzynski, Jeanne A. ; Miller, Ethan D. ; Gu, Xiangjun ; Huang, Maosheng ; Chang, David W. ; Ye, Yuanqing ; Hildebrandt, Michelle A.T. ; Klein, Alison ; Zhao, Ren ; Lippman, Scott M. ; Wu, Xifeng. / Determinants and prognostic value of quality of life in patients with pancreatic ductal adenocarcinoma. In: European Journal of Cancer. 2018 ; Vol. 92. pp. 20-32.
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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.",
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author = "Yang Deng and Huakang Tu and Pierzynski, {Jeanne A.} and Miller, {Ethan D.} and Xiangjun Gu and Maosheng Huang and Chang, {David W.} and Yuanqing Ye and Hildebrandt, {Michelle A.T.} and Alison Klein and Ren Zhao and Lippman, {Scott M.} and Xifeng Wu",
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AU - Tu, Huakang

AU - Pierzynski, Jeanne A.

AU - Miller, Ethan D.

AU - Gu, Xiangjun

AU - Huang, Maosheng

AU - Chang, David W.

AU - Ye, Yuanqing

AU - Hildebrandt, Michelle A.T.

AU - Klein, Alison

AU - Zhao, Ren

AU - Lippman, Scott M.

AU - Wu, Xifeng

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N2 - 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.

AB - 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.

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KW - Pancreatic ductal adenocarcinoma

KW - Prognostic indicator

KW - Quality of life

KW - Short Form-12

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