Dataset Information

Patient Perceptions of Decision-making and Quality-of-life Following Surgical Resection of Pancreatic Adenocarcinoma: A Mixed-methods Study.

ABSTRACT: Pancreatic adenocarcinoma (PDAC) remains a highly lethal disease, with surgery, the only opportunity for cure, accompanied by high rates of morbidity. Understanding patients' lived experiences after surgical resection of PDAC is critical to knowing whether the decision to undergo surgery was worth it for these patients.

Methods

We performed a convergent, mixed-methods study with patients who underwent resection of PDAC between January 1, 2019, and January 8, 2020. Quantitative data (medical record review and 3 questionnaires) were analyzed using descriptive statistics. Qualitative data (semistructured interviews) were analyzed using the constant comparative method. Data were then compared for congruence.

Results

Eighteen of 22 eligible participants completed interviews and 11 completed questionnaires. Data collection occurred at a median of 14.2 months (IQR 11.6-16.3) from surgery. We identified 4 main themes. First, persistent negative symptoms were common for patients, but patients adapt to these and are satisfied with their "new normal." Second, patients have varied and continually evolving mindsets throughout their cancer journey. Third, despite decreased quality-of-life, patients have a high degree of satisfaction with their decision to pursue surgery. Finally, patients were okay with a passive role in decision-making around surgery. Despite variable involvement in decision-making and outcomes, no participants reported regret over the decision to pursue surgery.

Discussion

This nuanced account of patients' lived experiences following surgery for PDAC allows for an improved understanding of the impact of pancreatic resection on patients. Surgeons can use these data to improve preoperative counseling for patients with PDAC and help guide them to making the correct decisions about surgery.

SUBMITTER: Bleicher J

PROVIDER: S-EPMC9780039 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Patient Perceptions of Decision-making and Quality-of-life Following Surgical Resection of Pancreatic Adenocarcinoma: A Mixed-methods Study.

Bleicher Josh J Place Aubrey A Harris Alex H S AHS Scaife Courtney L CL Huang Lyen C LC

Annals of surgery open : perspectives of surgical history, education, and clinical approaches 20221025 4

Pancreatic adenocarcinoma (PDAC) remains a highly lethal disease, with surgery, the only opportunity for cure, accompanied by high rates of morbidity. Understanding patients' lived experiences after surgical resection of PDAC is critical to knowing whether the decision to undergo surgery was worth it for these patients.<h4>Methods</h4>We performed a convergent, mixed-methods study with patients who underwent resection of PDAC between January 1, 2019, and January 8, 2020. Quantitative data (medic ...[more]

PMID: 36590886

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Project description:IntroductionPancreatic ductal adenocarcinoma (PDAC) is an aggressive neoplasm, with surgical resection and adjuvant chemotherapy the only curative treatment. Treatment-related toxicities place a considerable burden on patients although exercise training has shown promise is helping to manage such adversities and facilitate rehabilitation. The feasibility and safety of exercise training as a supportive therapy during adjuvant chemotherapy remains unknown.MethodsPatients with PDAC were screened post-surgical resection and enrolled in a 16-week, progressive, concurrent exercise programme alongside their chemotherapy regimen. Feasibility was the primary objective detailing recruitment, retention and adherence rates throughout as well as the safety and fidelity of the intervention. Secondarily, the impact on functional fitness and patient-reported outcomes was captured at baseline, post-intervention and 3-month follow up.ResultsEight patients consented to participate in this trial, with five proceeding to enrol in exercise training. Concurrent exercise training is feasible and safe during adjuvant chemotherapy and prevented an expected decline in functional fitness and patient-reported outcomes during this time.DiscussionThis case series provides preliminary evidence that concurrent exercise training during adjuvant therapy is safe, feasible and well tolerated, preventing an expected decline in functional fitness, muscular strength and health-related quality of life (HRQoL). Given the adverse effects of treatment, these findings are promising and provide further evidence for the inclusion of exercise training as a standard of care for surgical rehabilitation and managing treatment-related toxicities. Future research should explore the impact of exercise training during neoadjuvant chemotherapy, with prehabilitation now standard practice for borderline resectable disease.Trial registrationClinicalTrials.gov Identifier: NCT04305067, prospectively registered 12/03/2020, https://classic.Clinicaltrialsgov/ct2/show/NCT04305067 .

Dataset Information

Patient Perceptions of Decision-making and Quality-of-life Following Surgical Resection of Pancreatic Adenocarcinoma: A Mixed-methods Study.

Methods

Results

Discussion

Publications

Patient Perceptions of Decision-making and Quality-of-life Following Surgical Resection of Pancreatic Adenocarcinoma: A Mixed-methods Study.

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