Journal
SUPPORTIVE CARE IN CANCER
Volume 30, Issue 6, Pages 4879-4887Publisher
SPRINGER
DOI: 10.1007/s00520-022-06887-w
Keywords
Pancreatic neoplasms; Pancreatic ductal adenocarcinoma; Fear of cancer recurrence; Fear of cancer progression
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This study compared fear of tumor recurrence or progression (FOP) in pancreatic cancer patients treated with different methods and found that patients who underwent surgical resection had lower FOP scores at initial diagnosis. Better quality of life was associated with lower FOP in the best supportive care (BSC) group, but not in the surgical resection and palliative systemic treatment groups. FOP was not independently associated with overall survival (OS) in any of the subgroups.
Purpose It is plausible that patients with pancreatic cancer experience fear of tumor recurrence or progression (FOP). The aim of this study was to compare FOP in patients with pancreatic cancer treated with surgical resection, palliative systemic treatment, or best supportive care (BSC) and analyze the association between quality of life (QoL) and FOP and the effect of FOP on overall survival (OS). Methods This study included patients diagnosed with pancreatic cancer between 2015 and 2018, who participated in the Dutch Pancreatic Cancer Project (PACAP). The association between QoL and WOPS was assessed with logistic regression analyses. OS was evaluated using Kaplan-Meier curves with the log-rank tests and multivariable Cox proportional hazard analyses adjusted for clinical covariates and QoL. Results Of 315 included patients, 111 patients underwent surgical resection, 138 received palliative systemic treatment, and 66 received BSC. Patients who underwent surgical resection had significantly lower WOPS scores (i.e., less FOP) at initial diagnosis compared to patients who received palliative systemic treatment or BSC only (P < 0.001). Better QoL was independently associated with the probability of having a low FOP in the BSC (OR 0.95, 95% CI 0.91-0.98) but not in the surgical resection (OR 0.97, 95% CI 0.94-1.01) and palliative systemic treatment groups (OR 0.97, 95% CI 0.94-1.00). The baseline WOPS score was not independently associated with OS in any of the subgroups. Conclusion Given the distress that FOP evokes, FOP should be explicitly addressed by health care providers when guiding pancreatic cancer patients through their treatment trajectory, especially those receiving palliative treatment or BSC.
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