Informed Consent for the Surgical Treatment of Patients with Advanced Pancreatic Carcinoma

Takeshi Morimoto

Department of Enterological Surgery, Aichi Cancer Center Hospital

The prognosis for patients with pancreatic adenocarcinoma remains poor. While radical surgery with intraoperative radiation therapy (IORT) offers potentially curative treatment, only a minority of patients actually have resectable cancers. Even when all gross signs of disease are removed, relapse in the form of peritoneal dissemination or hepatic metastasis is common. Once a relapse occurs, the life that remains is brief and the quality of life (QOL) is poor. A total of 32 patients who had undergone operations by the same surgeon (the author) were available for current analysis. Of these, 17 patients had the lesion resected while 15 received palliaive operations. Informed consent for the surgical treatment with IORT and/or intraoperative hyperthermia treatment has to be obtained from the patiens with advanced pancreatic carcinoma. After being provided with details of their current status and treatment schedule, patietns agreed to receive the multimodal treatment. The physical and psychological QOL of the postoperative patients who were informed of their cance stage were assessed from the comments or complaints from the patients and attending family members. Fifteen with and 5 patients without resection were found to have good QOL, while 2 patiens with and 10 without resection suffered from poor QOL. Among the patiens with poor QOL, one with and 8 without resection did not manage to leave the hospital before death. The most important problem is the mental and physical care of the patients who did not feel satisfied during the brief postopera-tive period prior to death from cancer.

Key words
informed consent, pancreatic adenocarcinoma, quality of life

Reprint requests
Takeshi Morimoto Department of Enterological Surgery, Aichi Cancer Center Hospital
1-1 Kanokoden, Chikusa-ku, Nagoya, 464 JAPAN

Accepted
June 12, 1996

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