{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:11Z","timestamp":1786978271858,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreatoduodenectomy (PD) for pancreatic cancer has a profound impact on patients' lives. However, the long\u2010term financial implications are poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Assess the financial burden of long\u2010term survivors who underwent PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent PD between January 2011 and June 2019 were identified. To evaluate the long\u2010term financial burden, patients surviving \u2265\u20093 years post\u2010resection were prospectively surveyed using the Comprehensive Score for financial Toxicity (COST\u2010FACIT) and a customized institutionally developed questionnaire. A logistic regression model predicting high financial toxicity was used to identify predictive factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 238 eligible patients, 137 (57.6%) responded. Responders had a median age of 66 (59\u201373) 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\u2010FACIT 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>One in three long\u2010term 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.27871","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T04:05:01Z","timestamp":1725509101000},"page":"232-241","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Financial Toxicity of Long\u2010Term Survivors Who Underwent Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9721-2808","authenticated-orcid":false,"given":"Hala","family":"Muaddi","sequence":"first","affiliation":[{"name":"Hepatobiliary and Pancreas Surgery Division, Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0874-1861","authenticated-orcid":false,"given":"Andrea","family":"Zironda","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreas Surgery Division, Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9297-0690","authenticated-orcid":false,"given":"Chi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Arizona Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Day","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick P.","family":"Starlinger","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreas Surgery Division, Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne G.","family":"Warner","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreas Surgery Division, Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory L.","family":"Smoot","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreas Surgery Division, Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Kendrick","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreas 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