Predictors of mortality in patients with hepatobiliary and pancreatic cancers

Background Hepatobiliary and pancreatic cancers are the most lethal malignancies, with consistently poor survival outcomes due to delayed diagnosis and limited therapeutic options. Identifying factors associated with mortality is essential for improving prognosis and tailoring supportive care. However, evidence remains limited regarding comprehensive predictors of mortality in this population. This study aimed to identify determinants of mortality using a biopsychosocial approach that incorporates demographic, clinical, laboratory, and psychological factors, including quality of life (QoL). Methods Patients diagnosed with hepatobiliary or pancreatic cancers were recruited from a university hospital between September 2022 and November 2023, and their mortality was followed up at 1 year from enrollment. Pain, anxiety, depression, and QoL were assessed using the Numeric Rating Scale, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-General, respectively. Clinical information and death records were obtained from electronic health records. Cox proportional hazards regression was performed to identify factors influencing mortality using SPSS 30.0. Results Among the 204 participants, Among the 204 participants, 81 (39.7%) of deaths were recorded. Higher physical well-being (HR = 0.95, 95% CI: 0.90, 0.99) and undergoing surgical treatment for cancer (HR = 0.38, 95% CI: 0.21, 0.70) were associated with lower mortality. In contrast, higher social well-being predicted increased mortality (HR = 1.12, 95% CI: 1.06, 1.19), which may indicate that patients with advanced disease receive more social support and caregiving. Elevated blood urea nitrogen also predicted higher mortality (HR = 1.03, 95% CI: 1.01, 1.07), suggesting that metabolic burden or renal dysfunction worsens outcomes. Conclusions Physical well-being, received surgical treatment, and blood urea nitrogen levels were significant predictors of mortality in patients with hepatobiliary and pancreatic cancers. Enhancing physical functioning, surgical treatment history, and monitoring metabolic indicators may improve prognostic assessment. While psychological factors, except QoL, did not directly predict mortality. The findings highlight the value of an integrated biopsychosocial approach for managing high-risk cancer populations.