Association between baseline quality of life and survival in patients with non-metastatic, advanced pancreatic cancer

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Background Borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) constitute a heterogeneous disease spectrum with variable tumour biology and treatment responses, making clinical decision-making challenging. Improved prognostic markers are needed to guide individualised treatment strategies. This study aims to determine whether quality of life (QoL) at the time of diagnosis is associated with survival in patients diagnosed with BRPC and LAPC.Methods Between 2018 and 2020, a total of 230 consecutive patients with BRPC and LAPC were included in a population-based study. Patients completed the EORTC QLQ-C30 questionnaire at the time of diagnosis. Clinical data were collected prospectively. The association between QoL and survival was assessed using Cox regression models.Results Baseline QoL data were available for 143 (62%) patients. Median overall survival from time of diagnosis was 14 (95% CI 11.1–16.9) months. Multivariate analyses showed that emotional functioning, financial impact and constipation were significantly associated with survival. Constipation was the strongest prognostic factor (HR 1.95, 95% CI 1.28–2.96, p < 0.001). Patients with a high constipation score had a median overall survival of 10 months (95% CI, 7.2–12.8) compared to 16 months (95% CI, 11.9–20.0) for those with a low score (p = 0.009).Conclusions In patients with BRPC and LAPC, several baseline QoL domains, especially constipation, are significant prognostic indicators. Routine QoL assessment may facilitate personalised, patient-centred care that improves both clinical outcomes and QoL during treatment.