TY - JOUR
T1 - Long-Term Quality of Life after Minimally Invasive vs Open Distal Pancreatectomy in the LEOPARD Randomized Trial
AU - Korrel, Maarten
AU - Roelofs, Anne
AU - van Hilst, Jony
AU - Busch, Olivier R
AU - Daams, Freek
AU - Festen, Sebastiaan
AU - Groot Koerkamp, Bas
AU - Klaase, Joost
AU - Luyer, Misha D
AU - van Oijen, Martijn G
AU - Verdonck-de Leeuw, Irma M
AU - Besselink, Marc G
AU - De Hingh, Ignace
AU - LEOPARD trial collaborators
N1 - Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Minimally invasive distal pancreatectomy (MIDP) shortens time to functional recovery and improves 30-day quality of life (QoL), as compared with open distal pancreatectomy (ODP) for nonmalignant disease. The impact of MIDP on QoL, cosmetic satisfaction, and overall major complications beyond 1-year follow-up is currently unknown. Study Design: The Minimally Invasive Versus Open Distal Pancreatectomy (LEOPARD) trial randomized 108 patients to MIDP (laparoscopic or robotic) or ODP in 14 Dutch centers (April 2015 to March 2017). The primary outcome measure of this study was quality-adjusted life years (QALYs), as assessed with the EQ-5D. QoL was assessed using subscales of the EORTC QLQ-C30, PAN-26, and a body image questionnaire. The latter included a cosmetic satisfaction score (range 3–24), and a body image score (range 5–20). Differences between MIDP and ODP for QALYs, generic, and disease-specific QoL and body image were analyzed. Missing QoL data were imputed using multiple imputation. Results: In total, 84 patients were alive, with a median follow-up of 44 months; 62 of these patients (74%) completed the questionnaires (27 MIDP, 35 ODP). There was no significant difference in QALYs between the 2 groups (mean score 2.34 vs 2.46 years, p = 0.63), nor on the QoL subscales. Significant overall change in EQ-5D health utilities were found for both groups over time (p < 0.001). Patients in the MIDP group scored higher on cosmetic satisfaction (21 vs 14, p = 0.049). No differences between the 2 groups were observed for clinical outcomes such as major complications, readmissions, and incisional hernias. Conclusions: More than 3 years after distal pancreatectomy, no improvement in QALYs and overall QoL was seen after MIDP, whereas cosmetic satisfaction was higher after MIDP as compared with ODP.
AB - Background: Minimally invasive distal pancreatectomy (MIDP) shortens time to functional recovery and improves 30-day quality of life (QoL), as compared with open distal pancreatectomy (ODP) for nonmalignant disease. The impact of MIDP on QoL, cosmetic satisfaction, and overall major complications beyond 1-year follow-up is currently unknown. Study Design: The Minimally Invasive Versus Open Distal Pancreatectomy (LEOPARD) trial randomized 108 patients to MIDP (laparoscopic or robotic) or ODP in 14 Dutch centers (April 2015 to March 2017). The primary outcome measure of this study was quality-adjusted life years (QALYs), as assessed with the EQ-5D. QoL was assessed using subscales of the EORTC QLQ-C30, PAN-26, and a body image questionnaire. The latter included a cosmetic satisfaction score (range 3–24), and a body image score (range 5–20). Differences between MIDP and ODP for QALYs, generic, and disease-specific QoL and body image were analyzed. Missing QoL data were imputed using multiple imputation. Results: In total, 84 patients were alive, with a median follow-up of 44 months; 62 of these patients (74%) completed the questionnaires (27 MIDP, 35 ODP). There was no significant difference in QALYs between the 2 groups (mean score 2.34 vs 2.46 years, p = 0.63), nor on the QoL subscales. Significant overall change in EQ-5D health utilities were found for both groups over time (p < 0.001). Patients in the MIDP group scored higher on cosmetic satisfaction (21 vs 14, p = 0.049). No differences between the 2 groups were observed for clinical outcomes such as major complications, readmissions, and incisional hernias. Conclusions: More than 3 years after distal pancreatectomy, no improvement in QALYs and overall QoL was seen after MIDP, whereas cosmetic satisfaction was higher after MIDP as compared with ODP.
KW - Aged
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Kaplan-Meier Estimate
KW - Laparoscopy/adverse effects
KW - Length of Stay/statistics & numerical data
KW - Male
KW - Middle Aged
KW - Netherlands/epidemiology
KW - Pancreatectomy/adverse effects
KW - Pancreatic Neoplasms/mortality
KW - Postoperative Complications/epidemiology
KW - Quality of Life
KW - Quality-Adjusted Life Years
KW - Retrospective Studies
KW - Treatment Outcome
U2 - 10.1016/j.jamcollsurg.2021.08.687
DO - 10.1016/j.jamcollsurg.2021.08.687
M3 - Article
C2 - 34530127
SN - 1072-7515
VL - 233
SP - 730-739.e9
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 6
ER -