Association Among Cachexia Syndrome, Symptom Distress, and Quality of Life in Pancreatic Cancer Patients

Sunday, 30 July 2017

Yun-Jen Chou, MS
Department of Nursing, National Taiwan University, Taipei, Taiwan
Shiow-Ching Shun Jr., PhD, RN
School of Nursing, National Taiwan University, Taipei, Taiwan

Background: Cachexia syndrome is common in pancreatic cancer patients, and it will increase the mortality rate and decrease quality of life (QoL). However, there is no study with longitudinal design to explore the relationship among cachexia syndrome, symptom distress and QoL. Therefore, this study was to explore if the cachexia syndrome pre-operation was the significant factors to predict the longitudinal QoL after operation .


Methods: A longitudinal design was used in this study, and the data collected at 1~2 weeks before operation (T0), 2 months (T1), 3 months (T2), and 6 months (T3) after operation. Patients who scheduled to operate were recruited from surgery clinics at a medical center in Taipei. A structured questionnaire with Fatigue Symptom Inventory, Symptom Severity Scale, and Functional Assessment of Cancer Therapy-General Scale were used to collect patients’ fatigue, symptom distress and QoL, respectively. In addition, the questionnaire included patients’ demographic and clinical characteristic. In this study, cachexia syndrome was defined as patients’ total body weight loss > 5% over the past 6 months. The generalized estimating equation (GEE) was used to examine the significant associated factors with QoL after operation .


Results: Totally, 45 pancreatic cancer patients participated in this study. Among patients, 64.6% (N=29) was recognized as cachexia syndrome. Patients with cachexia syndrome had more percentage to accept chemotherapy (χ2=9.504; p=.002), suffer from fistula after operation (χ2=5.237; p=.022), and had higher level of fatigue intensity (t= -2.889; p=.06) and duration (t=-2.363; p=.023) than those with non-cachexia syndrome . In the GEE analysis, the patients with higher level of symptom distress had lower level of QoL (β = -.323, p < .0001) after control the significant different factors at baseline between the two groups.


Conclusions: This study found that cachexia syndrome wasn’t a significant associated factor with QoL. In addition, symptom distress was the significant factor affecting longitudinal QoL in pancreatic cancer patients. Therefore, healthcare providers should pay more attention and assist pancreatic cancer patients to manage symptom distress since they diagnosed to increase the level of QoL.