Development of a Core Outcome Set for Recurrent Acute and Chronic Pancreatitis: Results of a Delphi Poll
20 Nov 2024, 4 p.m.
Publication date: Available online 19 November 2024Source: PancreatologyAuthor(s): Lola Rahib, ...
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1. Prospective evaluation of Patient Related Outcome Measures (PROMS) and Health Related Quality of life (HRQoL) in patients with pancreatic cancer. Sanjay PANDANABOYANA, (THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
Pancreatic cancer patients undergoing surgery are exposed to high rates of perioperative complications and poor survival which can affect quality of life. Patient related outcome measures are used in cancer surgery due to often limited survival after morbid and complex treatments requiring careful appraisal and shared decision making.
There is paucity of data in patients with pancreatic cancer regarding the impact of pancreatic cancer in general and postoperative complications on patient related outcome measures (PROMS). Furthermore, the effect of surgical treatment on PROMS is unknown. This prospective study aims to longitudinally assess PROMS using the core set of patient reported outcomes in pancreatic cancer (COPRAC) questionnaire and (EORTC) QLQ-C30 and the pancreatic cancer module EORTC QLQ-PAN26 for all patients undergoing pancreatic surgery for malignant pathology.
This also aims to evaluate the association between postoperative complications and PROMS and HRQoL in the short-term (within 30 days) and long-term (after 3 and 6 months) in order to find out whether and to what extent complications (none/grade I vs. minor (grade II) vs. major (grade III-V)) influence the PROMs and HRQOL.
PEI is highly prevalent in chronic pancreatitis with incidence of 85%.(1-5) The development of PEI has substantial implications, with malabsorption having a significant impact on a patient’s symptom burden, quality of life and survival. Symptom reporting has identified that 80% of patients with PEI have abdominal pain, 64% bloating symptoms, 75% experience regular and troublesome diarrhoea and 67% report weight loss.(6) The resultant malnutrition has been shown to increase the risk of osteoporosis (and the associated low impact fractures), cardiovascular events and sarcopenia.(7-10) Recently both reduced survival and cardiac events have been reported more frequently among patients with chronic pancreatitis and not receiving PEI treatment. (11, 12) Post pancreatic resection, PEI is associated with increased post-operative complications, longer hospital stays and higher costs.(13-15) It has also been shown that appropriate treatment with PERT is associated with symptom improvement, improved QOL index scores and significant survival advantages.(16-20)
The development of a novel metabolomic test to diagnose and quantify pancreatic exocrine insufficiency among patients with chronic pancreatitis. The DETECTION study.
2020 PSGBI funding - £10,000 Ms Sarah Powell Brett, University of Birmingham
Pancreatic exocrine insufficiency is prevalent in pancreatic cancer, cystic fibrosis and chronic pancreatitis and has significant implications for quality of life and survival. The Current diagnostic tests are far from ideal, either having poor sensitivity or being time consuming and unpleasant.
Metabolomics is the study of small molecules in blood and other human tissues. The ‘food metabolome’ can be defined as ‘the part of the human metabolome directly derived from the digestion of food’. This study aims to develop a metabolomic 'fingerprint' of PEI that will form the basis for a blood test with the potential to diagnose and quantify PEI.
Blood will be taken from patients with PEI (from pancreatic cancer patients as a main study cohort and the from patients with cystic fibrosis and chronic pancreatitis as sub-studies) and from healthy controls after a fatty test meal and sent for metabolomics analysis. Plasma samples will be analysed using untargeted ultra-performance liquid chromatography-mass spectrometry allowing the detection of between 1500 and 2000 metabolites to identify metabolites most predictive of PEI.