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- Title
The prognostic factors and trajectory of HRQOL in patients with pancreatic cancer who received psychiatric intervention.
- Authors
Sugimoto, Hiroyuki; Kawashima, Hiroki; Ohno, Eizaburo; Hayashi, Daijuro; Kuwahara, Takamichi; Morishima, Tomomasa; Kawai, Manabu; Suhara, Hiroki; Takeyama, Tomoaki; Yamamura, Takeshi; Funasaka, Kohei; Nakamura, Masanao; Miyahara, Ryoji; Watanabe, Osamu; Ishigami, Masatoshi; Suzuki, Miho; Kimura, Hiroyuki; Ozaki, Norio; Hashimoto, Senju; Goto, Hidemi
- 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 6 months 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 3 months 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.
- Subjects
QUALITY of life; CANCER patients; PANCREATIC cancer; PSYCHIATRIC consultation; MENTAL health services; PSYCHOLOGICAL distress; PROGNOSIS
- Publication
Journal of Gastroenterology & Hepatology, 2016, Vol 31, Issue 3, p685
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/jgh.13172