BASELINE quality of life at diagnosis was strongly associated with survival outcomes in patients with non-metastatic advanced pancreatic cancer. This population-based study evaluated whether patient-reported well-being at the time of diagnosis could provide clinically meaningful prognostic information for borderline resectable and locally advanced pancreatic cancer, two groups marked by substantial heterogeneity in tumor biology and treatment response.
Quality of Life as a Prognostic Marker
Quality of life was assessed using the EORTC QLQ-C30 questionnaire completed at diagnosis. Of the 230 patients enrolled between 2018 and 2020, baseline data were available for 143 individuals. Median overall survival across the cohort was 14 months. In multivariate analyses, several quality-of-life domains demonstrated significant associations with survival. Emotional functioning and financial impact were independent predictors, but constipation emerged as the most influential factor.
Patients with high constipation scores had a median overall survival of 10 months, compared with 16 months for individuals reporting low scores. The hazard ratio for constipation was 1.95, indicating nearly double the risk of death among patients experiencing substantial symptom burden at diagnosis.
Implications for Advanced Pancreatic Cancer Care
The findings highlight the prognostic value of structured quality-of-life assessments in clinical practice. Baseline quality of life, especially constipation severity, may help clinicians better stratify risk, guide treatment decisions and anticipate supportive care needs. As borderline resectable and locally advanced pancreatic cancer often require highly individualized treatment planning, integrating patient-reported outcomes at diagnosis may strengthen clinical decision-making.
Routine quality-of-life measurement could also support broader goals of personalized and patient-centered care, ensuring that symptom relief, functional status and daily well-being remain integral components of management strategies. The study supports the growing recognition that symptom domains traditionally considered secondary may hold meaningful prognostic significance.
Reference: Christiansen GG et al. Association between baseline quality of life and survival in patients with non-metastatic, advanced pancreatic cancer. Scand J Gastroenterol. 2025;1-8.
