Pancreascancer & QoL : kirurgi og adjuvant behandling

Abstract

Abstract

In previous literature there is little difference in survival between the classic Whipple procedure and pylorus-preserving pancreaticoduodenectomy. The same goes for survival after regional lymphadenectomy (RLA) and extended lymphadenectomy (ELA). Studies done on adjuvant therapy show a survival benefit for chemotherapy. Before taking a stand to what treatment is the best for the patient, another perspective is required. This paper is focusing on the effect of different treatments for pancreatic cancer, with emphasis on QoL as the outcome. I wanted to find out if there was a difference in QoL between the various procedures, and between adjuvant treatments. The results from articles I have read are pointing in the same direction as to what effect different surgical procedures have, when it comes to QoL in these patients. The results show that there is a reduction in QoL after surgery, irrelevant of what type of procedure has been performed (PPD, PPPD or bypass surgery). This reduction is reversible, and returns to preoperative levels after 3 - 6 months postoperative. Extended lymphadenectomy has a more profound effect on QoL, and showes a greater reduction compared to RLA. When it comes to adjuvant therapy and how it is affecting patients’ QoL, it is hard to come to a conclusion other than that nothing is certain. It is obvious that more research is needed in this area of medicine, and that there is still much to discover.