Quality-of-life testing may predict malignancy and survival in patients with pancreatic disease

DETROIT — Quality-of-life measures used routinely to assess treatment outcomes for patients with pancreatic disease may be used to predict both malignancy and survival for those patients, according to a study by Henry Ford Hospital.

Researchers found that pre-treatment quality-of-life scores could predict malignancy in patients with pancreatic lesions and survival in those who are found to have malignancies.

“Our findings suggest that pretreatment quality-of-life scores may show which patients will have a poor survival and therefore could avoid aggressive, but futile, treatment,” says Vic Velanovich, M.D., chief of General Surgery at Henry Ford Hospital and lead author of the study.

Study results will be presented May 3 at the Digestive Diseases Week conference in New Orleans.

The study assessed 323 surgical patients with pancreatic lesions who completed the SF-36, a short-form health survey which contains eight domains measuring quality of life including physical functioning, role-physical, role-emotional, bodily pain, vitality, mental health, social functioning, and general health.

Patients with pain related to known chronic pancreatitis were excluded, however, patients with undiagnosed solid or cystic lesions were included. Of those patients, 210 were found to have malignancies.

“Patients with pancreatic malignancies had lower scores than patients with benign pancreatic disease,” says Dr. Velanovich. “Patients with non-cancerous lesions were found to have better overall functioning than those with malignancies.”

Patients with malignancies surviving less than one year had lower scores, even after controlling for the stage of their disease.

Dr. Velanovich explains that the lower scores may reflect more advanced disease or frailties which identify patients with poor prognoses.

“We were even able to predict from which patients we would be able to surgically remove the cancer entirely and from which patients we would not,” says Dr. Velanovich. “Additional studies are needed to confirm whether quality-of-life measures are a reliable way to determine if patients should seek alternative treatment and when to abandon aggressive treatments.”

The pancreas is a gland behind the stomach and in front of the spine that produces juices that help break down food and hormones that help control blood sugar levels. Problems with the pancreas can lead to many health problems including pancreatitis, an inflammation of the pancreas and pancreatic cancer. In 2009, an estimated 42,000 new cases of pancreatic cancer and 35,000 deaths were reported, according to the National Institutes of Health.

EDITOR’S NOTE: Dr. Vic Velanovich is available for interviews.

Funding: Henry Ford Hospital

8 a.m., EST, Monday, May 3, 2010

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