Volume 131, Issue 2 pp. 232-241
RESEARCH ARTICLE

Financial Toxicity of Long-Term Survivors Who Underwent Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma

Hala Muaddi

Hala Muaddi

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Andrea Zironda

Andrea Zironda

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Chi Zhang

Chi Zhang

Department of Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA

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Courtney Day

Courtney Day

Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA

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Patrick P. Starlinger

Patrick P. Starlinger

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Susanne G. Warner

Susanne G. Warner

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Rory L. Smoot

Rory L. Smoot

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Michael L. Kendrick

Michael L. Kendrick

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Sean P. Cleary

Sean P. Cleary

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Mark J. Truty

Mark J. Truty

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Cornelius A. Thiels

Corresponding Author

Cornelius A. Thiels

Hepatobiliary and Pancreas Surgery Division, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

Correspondence: Cornelius A. Thiels ([email protected])

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First published: 05 September 2024
Citations: 1

ABSTRACT

Background

Pancreatoduodenectomy (PD) for pancreatic cancer has a profound impact on patients' lives. However, the long-term financial implications are poorly understood.

Objective

Assess the financial burden of long-term survivors who underwent PD.

Methods

Patients who underwent PD between January 2011 and June 2019 were identified. To evaluate the long-term financial burden, patients surviving ≥ 3 years post-resection were prospectively surveyed using the Comprehensive Score for financial Toxicity (COST-FACIT) and a customized institutionally developed questionnaire. A logistic regression model predicting high financial toxicity was used to identify predictive factors.

Results

Among 238 eligible patients, 137 (57.6%) responded. Responders had a median age of 66 (59–73) years, with 86.7% identifying as financial prosperous or comfortable. However, 33.3% experienced financial distress due to treatment costs, 27.3% demonstrated high financial toxicity on the COST-FACIT survey, and 37.2% made sacrifices to afford treatment. Only 8.9% stated that the treatment costs influenced their decisions, and the majority (85.9%) did not discuss financial implications with healthcare providers. Multivariable analysis identified younger age as a risk factor for high financial toxicity.

Conclusion

One in three long-term survivors experienced high financial toxicity, with younger age being a predictor. This emphasizes the need for efforts to provide comprehensive support and guidance to patients to navigate their oncological journey.

Data Availability Statement

Research data are not shared.

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