Predictive role of the prognostic nutritional index in patients with pancreatic ductal adenocarcinoma who underwent neoadjuvant chemoradiotherapy followed by curative pancreatic resection: A retrospective study using prospectively collected data

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-03-10 DOI:10.1002/jhbp.1424

Hironobu Suto, Hiroyuki Matsukawa, Yasuhisa Ando, Minoru Oshima, Takuro Fuke, Mina Nagao, Hiroki Yamana, Hideki Kamada, Kensuke Kumamoto, Keiichi Okano

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引用次数: 0

Abstract

Background

Despite a strong association between nutritional indices and disease prognosis, evidence regarding the evaluation of nutritional indices after preoperative treatment for pancreatic ductal adenocarcinoma (PDAC) is insufficient. We evaluated the clinical significance of the prognostic nutritional index (PNI) in patients with resectable (R-) and borderline resectable (BR-) PDAC who received neoadjuvant chemoradiotherapy (NACRT) followed by pancreatic resection.

Methods

We assessed 153 patients with R- and BR-PDAC who underwent NACRT followed by curative resection between 2009 and 2022. We evaluated the association between preoperative PNI after NACRT and short- and long-term outcomes.

Results

The median preoperative PNI value after NACRT was 42.1, and the optimal cutoff value from the time-dependent receiver operating characteristic curve was 38.6. The low PNI group (PNI < 38.6, n = 44) exhibited significantly worse inflammatory parameters, surgical outcomes, and prognoses than the high PNI group (PNI ≥ 38.6, n = 109). Multivariate analysis identified preoperative PNI ≤ 38.6 (hazard ratio [HR]: 2.32, 95% confidence interval [CI]: 1.00–5.38, p = .049), blood loss ≥1642 mL (HR: 3.05, 95% CI: 1.65–5.64, p < .001), node positive pathology (HR: 2.10, 95% CI: 1.32–3.34, p = .002), and lack of postoperative adjuvant chemotherapy (HR: 3.55, 95% CI: 2.05–6.15, p < .001) as significant predictors of overall survival.

Conclusions

For patients with R- and BR-PDAC receiving preoperative treatment, it is imperative to closely monitor their nutritional status when determining the optimal surgical procedure timing.

Abstract Image

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胰腺导管腺癌患者接受新辅助化放疗后进行胰腺根治性切除术的预后营养指数的预测作用：一项利用前瞻性收集数据进行的回顾性研究。

背景：尽管营养指数与疾病预后密切相关，但有关胰腺导管腺癌（PDAC）术前治疗后营养指数评估的证据不足。我们评估了接受新辅助化放疗（NACRT）和胰腺切除术的可切除（R-）和边缘可切除（BR-）PDAC 患者预后营养指数（PNI）的临床意义：我们对2009年至2022年期间接受新辅助化放疗（NACRT）后进行根治性切除的153例R-和BR-PDAC患者进行了评估。我们评估了 NACRT 术前 PNI 与短期和长期预后之间的关系：NACRT术前PNI中位值为42.1，根据时间依赖性接收器操作特征曲线得出的最佳临界值为38.6。低 PNI 组（PNI 结论：低 PNI 组患者术前 PNI 值为 42.1：对于接受术前治疗的 R- 和 BR-PDAC 患者，在确定最佳手术时间时，必须密切监测他们的营养状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.