Long-term health-related quality of life in a complete-case subgroup of disease-free survivors after pancreatic resection: A single-centre exploratory study

Abstract Background Health-related quality of life (HRQoL) has become an important outcome measure following pancreatic resection, particularly because postoperative morbidity remains high despite improvements in perioperative mortality. Although short- and mid-term changes in HRQoL over time have been described, data on long-term outcomes in disease-free survivors remain limited. This study explored longitudinal HRQoL changes in a complete-case subgroup of disease-free survivors after pancreatic resection and contextualized long-term outcomes against general population reference values. Methods This single-centre exploratory longitudinal study assessed HRQoL preoperatively and during follow-up using the validated EORTC QLQ-C30 and QLQ-PAN26 questionnaires. Assessments were grouped into baseline, early postoperative follow-up (1–3 months), and long-term follow-up. Seventeen of 115 initially scheduled patients (14.8%), corresponding to 17 of 67 patients who entered longitudinal HRQoL follow-up (25.4%), were disease-free and had complete data across all three analytical periods. Changes over time were analyzed using Friedman’s test with Kendall’s W as the effect size measure, and the results were descriptively compared with Slovenian general population reference values. All analyses were exploratory and limited to these 17 complete-case disease-free survivors. Results Nominal unadjusted p-values below 0.05 were observed for role functioning ( p = 0.014), social functioning ( p = 0.004), financial difficulties ( p = 0.029), weight loss ( p = 0.002), future worries ( p < 0.001), and planning of activities ( p < 0.001). HRQoL deterioration was most pronounced in the early postoperative period, followed by improvement at long-term follow-up. In the descriptive unmatched comparison, selected functional domains at long-term follow-up approached general population reference values, while insomnia, fatigue, and digestive disturbances persisted. Conclusions In this exploratory analysis of 17 highly selected complete-case disease-free survivors, HRQoL declined in the early postoperative period and improved at long-term follow up in several domains. These findings are exploratory and hypothesis-generating and should not be generalized beyond comparable complete-case survivor populations.