34: Impact of Neoadjuvant Treatment on Psychosocial Wellbeing in Patients with Pancreatic Cancer

Pts with localized PC completed validated Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires prior to treatment (pretx), mid chemotherapy (mid-chemo), post chemotherapy (post-chemo), post chemoradiation/prior to surgery (preop), and at 6 weeks and 6 months (mo) after surgery (postop). T-scores and generalized linear mixed models with fixed effect for event and random intercept and slope for each patient were generated. Mean T-scores were compared to the general population (GP), T=50. Dunnet adjusted p-values were used to compare the mean T-score at each timepoint to pretx.


Results: Of the 120 pts with localized PC who responded, the majority were white (n=107, 89%), male (n=68, 57%) and the median age was 65 (IQR 15). Compared to the GP, depression scores were never significantly higher but patient anxiety scores were significantly higher at pretx (T=56; 95%CI: 54-58) and preop (T=52; 95%CI: 51-54). Compared to the GP, social engagement was significantly lower at 6 weeks postop (T=47; 95%CI: 45-49).  Over the course of treatment, pretx anxiety scores were significantly higher than all subsequent timepoints (p< 0.05, Figure 1). Compared to pretx, depression scores were significantly lower at the post-chemo (51 vs. 48; p=0.02) and preop (T=51 vs. 48, p=0.02) timepoints. Compared to pretx, social engagement was significantly lower at 6 weeks postop (T=50 vs. 47, p=0.01) but returned to pretx levels at 6 mo postop.  


Conclusions: Treatment of PC significantly impacts psychosocial health. The pretx and preop periods are associated with anxiety, while treatment did not increase reported depression. Surgery negatively impacts the ability to engage in social activities. All measured fields return to baseline 6 mo postop. This is important data for shared decision-making, identification of at-risk patients, and establishes a roadmap for targeted interventions.