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Hepato-pancreato-biliary

E215: Patient Expectations about the Oncologic Benefit of Surgery Among Patients Undergoing Pancreatectomy for Pancreatic Cancer

Introduction: Pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) is rarely curative, though data are lacking about whether patients understand the risks/benefits of surgical resection. We aimed to prospectively study patient understanding by distributing a survey to patients planning to undergo pancreatectomy for PDAC.

Methods:

A 14-question survey was constructed in collaboration with a psychometrician and distributed to patients planning to undergo pancreatectomy at eight geographically diverse institutions with high volumes of pancreatic surgery between 2020 and 2022. The survey assessed self-reported patient demographics (age, income, race, gender, marital status, education level, or type of insurance), understanding of post-resection outcomes, and perceived quality of communication with their surgeon. Responses were graded on 4- or 5-point Likert-style scales. Associations between demographics and survey responses were assessed using chi-squared and Fisher’s exact tests.

Results: Patients returned 152 surveys (response rate 39%). Average age of respondents was 60 years (SD 8.19). Most participants self-reported White (n=125, 84.5%) or Black race (n=20, 13.5%). Median self-reported annual income was $60,000. Of respondents that reported understanding the purpose of surgery, the majority believed surgery was either “somewhat likely” or “very likely” to cure their cancer (n=126, 89%), with over half (n=77, 55%) believing surgery was “very likely” to cure their cancer (Figure 1). With respect to surgeon communication, 134 respondents (89%) reported their surgeon listened carefully to them “always,” 16 respondents (11%) reported “usually,” and none reported “sometimes” or “never.” No associations were observed among demographic characteristics and understanding of post-resection outcomes.

Conclusions: Most patients undergoing pancreatectomy for PDAC express the belief that surgery is somewhat or very likely to cure their disease and most patients report high ratings of communication with their surgeon. These data suggest that while perceived communication quality is excellent, opportunities exist for surgical oncologists to improve pre-operative counseling and ensure patients have accurate information to support complex decision-making.

Learning Objectives:

  • Understand that most patients undergoing pancreatectomy for PDAC express the belief that surgery is somewhat or very likely to cure their disease.
  • Understand that most patients undergoing pancreatectomy for PDAC report high ratings of communication with their surgeon.
  • Recognize that while perceived communication quality is excellent, opportunities exist for surgical oncologists to improve pre-operative counseling and ensure patients have accurate information to support complex decision-making.