Trajectories of quality of life in pancreatic cancer survivors during the first year after surgery: a longitudinal study

Abstract

Abstract Although quality of life (QOL) improves over time for most pancreatic cancer patients after surgery, some patients may show different patterns of QOL. Beyond determining distinct QOL trajectories, identifying characteristics of patients who have different trajectories can help identify pancreatic cancer patients who may benefit from intervention. We aimed to identify trajectories of QOL in pancreatic cancer patients for one year after the surgery, to determine the factors influencing these changes. This longitudinal study recruited 120 pancreatic cancer patients, and their QOL, anxiety, depression, social support, self‑efficacy, and sleep quality were assessed. Data were collected at 1 month (T1), 3month (T2), 6month (T3), and 12month (T4) after surgery. Group-Based Multivariate Trajectory Modeling (GBMTM) was used to identify distinct subgroups of patients with similar patterns of QOL change after surgery. A univariate analysis was used to determine which variables were associated with trajectory membership. A multinomial logistic regression was performed to identify factors associated with trajectory group membership. 104 patients were analyzed and identified with three trajectory groups, the low, moderate and high QOL group. All of three groups exhibited a sustained upward trend in functional domain scores, followed by a slight decline at 12 months. Correspondingly, symptom domain scores showed a consistent downward trajectory across all groups, with a slight increase observed at 12 months. Compared with the high QOL group, the odds of the low QOL group were 1.139 times higher in the SDS (OR = 1.139, 95% CI: 1.037–1.252, P  = 0.007), and the odds of the low QOL group were 1.762 times higher than the high QOL group in the PSQI (OR = 1.762, 95% CI: 1.161–2.674, P  = 0.008). Compared to the high QOL group, the odds of the moderate QOL group were 1.127 times higher in the SDS (OR = 1.127, 95% CI: 1.037–1.226, P  = 0.005), and the odds of the moderate QOL group were 1.535 times higher in the PSQI (OR = 1.535, 95% CI: 1.055–2.235, P  = 0.025). Conversely, occupation, BMI, SAS scores, and GSES scores showed no statistically significant effect on trajectory group ( P  > 0.05). Identifying high‑risk groups for reduced QOL after surgery is necessary. Moreover, psychosocial interventions and sleep methodologies should be provided to alleviate psychological symptoms and improve sleep quality to enhance patients’ QOL.