Yukiko Niwa
   Department   School of Medicine(Yachiyo Medical Center), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Clinical Impact of Neoadjuvant Therapy on Nutritional Status in Pancreatic Cancer.
Journal Formal name：Annals of surgical oncology
Abbreviation：Ann Surg Oncol
ISSN code：15344681/10689265
Domestic / ForeginForegin
Volume, Issue, Page 25(11),pp.3365-3371
Author and coauthor Tashiro Mitsuru, Yamada Suguru, Sonohara Fuminori, Takami Hideki, Suenaga Masaya, Hayashi Masamichi, Niwa Yukiko, Tanaka Chie, Kobayashi Daisuke, Nakayama Goro, Koike Masahiko, Fujiwara Michitaka, Fujii Tsutomu, Kodera Yasuhiro
Publication date 2018/10
Summary 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.
DOI 10.1245/s10434-018-6699-8
PMID 30097739