The Impact of Pre-Existing Psychiatric Disorders on Outcomes After Pancreatic Cancer Surgery

OBJECTIVES: Comorbid psychiatric illness has been associated with worse outcomes following some major surgical procedures. We hypothesized that patients with pre-existing mood disorders would have worse postoperative and oncologic outcomes after pancreatic cancer resection. METHODS: This retrospective cohort study analyzed Surveillance, Epidemiology, & End Results patients with resectable pancreatic adenocarcinoma. A pre-existing mood disorder was classified if a patient was diagnosed and/or treated with medication approved for depression/anxiety within 6 months before surgery. RESULTS: Of 1305 patients, 16% had a pre-existing mood disorder. Mood disorders had no impact on hospital length of stay (12.9 vs 13.2 days, P = 0.75), 30-day complications (26% vs 22%, P = 0.31), 30-day readmissions (26% vs 21%, P = 0.1), or mortality (30 days: 3% vs 4%, P = 0.35); only an increased 90-day readmissions rate (42% vs 31%, P = 0.001) was observed. No effect on adjuvant chemotherapy receipt (62.5% vs 69.2%, P = 0.06) or survival (24-months, 43% vs 39%, P = 0.44) was observed. CONCLUSIONS: Pre-existing mood disorders influenced 90-day readmissions after pancreatic resection, but not other postoperative or oncologic outcomes. These findings suggest that affected patients should be expected to have outcomes similar to patients without mood disorders.