The association between patient-reported postoperative recovery and health-related quality of life in patients undergoing pancreatic cancer surgery: an explorative single-centre study

Pancreaticoduodenectomy (PD) is associated with a long and complex recovery. Enhanced recovery programmes have improved short-term clinical outcomes, but there is a growing interest in patient-reported outcomes as an indicator for postoperative recovery. Health-related quality of life (HRQoL) and patient-reported postoperative recovery provide a wider perspective on the effects of surgery. However, the relationship between the two measures remains unexplored. Therefore, the aim of this study was to explore the relationship between HRQoL and patient-reported recovery in patients undergoing PD. This prospective, single-centre study included 77 participants who all underwent PD in the context of an enhanced recovery programme. Instruments used were the EQ-5D-3L and the SwQoL-24. Data was collected preoperatively and at 1,3,6,9, and 12 months postoperatively. Longitudinal trends were analysed using a mixed-effect repeated measures model. Predictive associations were explored via linear regression. The EQ-5D-3L improved, and the SwQoL-24 total score declined throughout the first year. The EQ-5D-3L Index and the VAS explained the SwQoR-24 value at six months and 12 months; R2 0.52/0.47 and 0.52/0.56, respectively. Preoperative EQ-5D-3L values predicted between (R2) 0.09-0.17 for 6 and 12-month SwQoR-24 values. Other tested factors were statistically non-significant. This study demonstrates a significant improvement in postoperative recovery as well as HRQoL during the first year after PD, with a strong association between the two measures. The findings also suggest that the EQ-5D-3L index and the EQ VAS have a significant but limited predictive value for postoperative recovery. Other demographical and care-related factors did not predict levels of recovery quality.