Changes in nutritional status and fatigue and their associations with quality of life in patients with pancreatic cancer after surgery: A 12-month longitudinal study

Objective: This study examined changes in nutritional status, fatigue, and quality of life, and identified longitudinal factors influencing changes in quality of life in patients with pancreatic cancer before and 12 months after surgery. Methods: A longitudinal, correlational, single-group study was conducted on 89 patients with operable pancreatic cancer in Taiwan. Data were collected preoperatively (T0) and at 3 (T1), 6 (T2), and 12 (T3) months post-surgery using questionnaires- Mini Nutritional Assessment, Fatigue Symptom Inventory, and Functional Assessment of Cancer Therapy-General-and through bioelectrical impedance analysis, handgrip strength measurement, and the 30-s sit-to-stand test. Generalized estimating equation models were used to analyze variable changes and associated factors. Results: Body weight (T1, p <0.01; T2, p <0.01; T3, p < 0.01), visceral fat mass (T1, p <0.01; T2, p <0.01; T3, p < 0.01), and handgrip strength (T1, p < 0.01; T2, p < 0.01; T3, p < 0.01) decreased significantly after surgery. The quality of life significantly improved at T2 and T3 (T2, p = 0.04; T3, p = 0.04). Lower visceral fat mass ((3 = -2.27, p < 0.01), better overall nutritional status ((3 =1.54, p < 0.01), and lower fatigue ((3 = -0.26, p < 0.01) were associated with higher quality of life from T0-T3. Conclusions: Patients with pancreatic cancer should have their nutritional status and fatigue assessed early and continuously for at least 12 months post-surgery. Early preoperative interventions that can reduce visceral fat mass, combat malnutrition, and alleviate fatigue are recommended.