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Clinical Impact of Neoadjuvant Therapy on Nutritional Status in Pancreatic Cancer

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The association between neoadjuvant therapy (NAT) and nutritional status in pancreatic cancer (PC) is unknown.

Objective

The aim of this study was to assess the impact of NAT on nutritional status.

Methods

Overall, 161 patients who underwent pancreatoduodenectomy for PC between August 2010 and March 2017 were enrolled and were divided into two groups: the neoadjuvant group (NAG; n = 67) and the control group (CG; n = 94). Based on relative dose intensity (RDI), patients in the NAG group were further divided into RDI ≥ 80% (n = 39) and RDI < 80% (n = 19). Changes in nutritional index, inflammatory index, and inflammation-based prognostic scores during NAT and the perioperative period were assessed.

Results

Retinol-binding protein, prealbumin, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutrition index significantly worsened in the NAG after NAT (p = 0.007, p = 0.03, p = 0.04, p = 0.007, and p = 0.004, respectively). The recovery of rapid turnover proteins after postoperative day 5 was significantly worse in the NAG compared with the CG (p < 0.05), but tended to be more prompt in the RDI ≥ 80% group among the NAG. There was no significant difference in the incidence of postoperative complications, length of hospital stay, and time to postoperative adjuvant therapy between the NAG and the CG.

Conclusions

NAT for PC could aggravate nutritional status and hamper its postoperative recovery. Furthermore, malnutrition might decrease tolerance of NAT. These findings suggest the importance of nutritional support for patients with NAT in PC.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Mitsuru Tashiro MD, Suguru Yamada MD, PhD, Fuminori Sonohara MD, PhD, Hideki Takami MD, PhD, Masaya Suenaga MD, PhD, Masamichi Hayashi MD, PhD, Yukiko Niwa MD, PhD, Chie Tanaka MD, PhD, Daisuke Kobayashi MD, PhD, Goro Nakayama MD, PhD, Masahiko Koike MD, PhD, Michitaka Fujiwara MD, PhD & Yasuhiro Kodera MD, PhD

  2. Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan

    Tsutomu Fujii MD, PhD

Authors
  1. Mitsuru Tashiro MD
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  2. Suguru Yamada MD, PhD
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  3. Fuminori Sonohara MD, PhD
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  8. Chie Tanaka MD, PhD
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  13. Tsutomu Fujii MD, PhD
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  14. Yasuhiro Kodera MD, PhD
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Contributions

MT, SY, YK: Conception and design; YK, SY: Administrative support; HT, MS, YN, MH, SY, TF: Provision of study materials and patients; HT, MS, YN, MH, SY, TF: Collection and assembly of data; MT, SY: Interpretation and analysis of data; MT, FS, SY: Manuscript writing; Final approval of manuscript: all authors.

Corresponding author

Correspondence to Suguru Yamada MD, PhD.

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Disclosure

Mitsuru Tashiro, Suguru Yamada, Fuminori Sonohara, Hideki Takami, Masaya Suenaga, Masamichi Hayashi, Yukiko Niwa, Chie Tanaka, Daisuke Kobayashi, Goro Nakayama, Masahiko Koike, Michitaka Fujiwara, Tsutomu Fujii, and Yasuhiro Kodera have no conflicts of interest to declare.

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Tashiro, M., Yamada, S., Sonohara, F. et al. Clinical Impact of Neoadjuvant Therapy on Nutritional Status in Pancreatic Cancer. Ann Surg Oncol 25, 3365–3371 (2018). https://doi.org/10.1245/s10434-018-6699-8

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  • DOI: https://doi.org/10.1245/s10434-018-6699-8

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