Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer.

IF 3.5 3区医学 Q1 SURGERY

Asian Journal of Surgery Pub Date : 2024-11-12 DOI:10.1016/j.asjsur.2024.10.151

Hiromitsu Maehira, Haruki Mori, Nobuhito Nitta, Takeru Maekawa, Yusuke Nishina, Hajime Ishikawa, Katsushi Takebayashi, Sachiko Kaida, Toru Miyake, Masaji Tani

{"title":"Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer.","authors":"Hiromitsu Maehira, Haruki Mori, Nobuhito Nitta, Takeru Maekawa, Yusuke Nishina, Hajime Ishikawa, Katsushi Takebayashi, Sachiko Kaida, Toru Miyake, Masaji Tani","doi":"10.1016/j.asjsur.2024.10.151","DOIUrl":null,"url":null,"abstract":"Background: Adjuvant chemotherapy is a standard therapeutic option for resected pancreatic cancer. However, the risk factors for incompletion of adjuvant chemotherapy remain unclear.Methods: We retrospectively reviewed the medical records of 72 patients who underwent radical pancreatectomy and received S-1 adjuvant chemotherapy for pancreatic cancer. The patients were assigned to two groups according to their completion or incompletion of adjuvant chemotherapy. We compared the perioperative skeletal muscle mass index (SMI) and nutritional status using prognostic nutritional index (PNI) between the two groups.Results: The completion and incompletion groups included 46 (64 %) and 26 (36 %) patients, respectively. Overall survival was shorter in the incompletion group than in the completion group (median survival time, 20.2 months vs. 42.0 months; log-rank, p = 0.018). Decreasing rate of PNI (12.7 % vs. 0.2 %, p = 0.010) and decreasing rate of SMI (26.9 % vs. 12.5 %, p = 0.001) were significantly larger in the incompletion group than in the completion group. Multivariate analysis showed that decreasing rate of PNI (p = 0.016), decreasing rate of SMI (p = 0.013), and old age (p = 0.049) were independent risk factors for incompletion of S-1 adjuvant chemotherapy. Regarding the time-series variations, PNI improved from 1 to 3 months after pancreatectomy in the completion group (p = 0.006). Furthermore, the decreasing slope of SMI was stronger in the incompletion group.Conclusion: Postoperative decrease of PNI and SMI is associated with the incompletion of S-1 adjuvant chemotherapy.","PeriodicalId":55454,"journal":{"name":"Asian Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.asjsur.2024.10.151","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Adjuvant chemotherapy is a standard therapeutic option for resected pancreatic cancer. However, the risk factors for incompletion of adjuvant chemotherapy remain unclear.

Methods: We retrospectively reviewed the medical records of 72 patients who underwent radical pancreatectomy and received S-1 adjuvant chemotherapy for pancreatic cancer. The patients were assigned to two groups according to their completion or incompletion of adjuvant chemotherapy. We compared the perioperative skeletal muscle mass index (SMI) and nutritional status using prognostic nutritional index (PNI) between the two groups.

Results: The completion and incompletion groups included 46 (64 %) and 26 (36 %) patients, respectively. Overall survival was shorter in the incompletion group than in the completion group (median survival time, 20.2 months vs. 42.0 months; log-rank, p = 0.018). Decreasing rate of PNI (12.7 % vs. 0.2 %, p = 0.010) and decreasing rate of SMI (26.9 % vs. 12.5 %, p = 0.001) were significantly larger in the incompletion group than in the completion group. Multivariate analysis showed that decreasing rate of PNI (p = 0.016), decreasing rate of SMI (p = 0.013), and old age (p = 0.049) were independent risk factors for incompletion of S-1 adjuvant chemotherapy. Regarding the time-series variations, PNI improved from 1 to 3 months after pancreatectomy in the completion group (p = 0.006). Furthermore, the decreasing slope of SMI was stronger in the incompletion group.

Conclusion: Postoperative decrease of PNI and SMI is associated with the incompletion of S-1 adjuvant chemotherapy.

查看原文本刊更多论文

预后营养指数和骨骼肌指数对未完成胰腺癌辅助化疗的临床影响。

背景：辅助化疗是切除胰腺癌的标准治疗方案。然而，辅助化疗未完成的风险因素仍不清楚：我们回顾性研究了 72 例接受根治性胰腺切除术并接受 S-1 辅助化疗的胰腺癌患者的病历。根据完成或未完成辅助化疗将患者分为两组。我们比较了两组患者围手术期的骨骼肌质量指数（SMI）和预后营养指数（PNI）：结果：完成组和未完成组分别有 46（64%）和 26（36%）名患者。未完成组的总生存期短于完成组（中位生存期为 20.2 个月对 42.0 个月；对数秩，P = 0.018）。未完成组的 PNI 下降率（12.7% 对 0.2%，P = 0.010）和 SMI 下降率（26.9% 对 12.5%，P = 0.001）明显高于完成组。多变量分析显示，PNI下降率（p = 0.016）、SMI下降率（p = 0.013）和年龄（p = 0.049）是未完成S-1辅助化疗的独立风险因素。在时间序列变化方面，胰腺切除术后 1 至 3 个月，完成组的 PNI 有所改善（p = 0.006）。此外，SMI的下降斜率在未完成组更强：结论：术后 PNI 和 SMI 的下降与未完成 S-1 辅助化疗有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Asian Journal of Surgery 医学-外科

CiteScore

3.60

自引率

31.40%

发文量

1589

审稿时长

33 days

期刊介绍： Asian Journal of Surgery, launched in 1978, is the official peer-reviewed open access journal of the Asian Surgical Association, the Taiwan Robotic Surgery Association, and the Taiwan Society of Coloproctology. The Journal is published monthly by Elsevier and is indexed in SCIE, Medline, ScienceDirect, Scopus, Embase, Current Contents, PubMed, Current Abstracts, BioEngineering Abstracts, SIIC Data Bases, CAB Abstracts, and CAB Health. ASJSUR has a growing reputation as an important medium for the dissemination of cutting-edge developments in surgery and its related disciplines in the Asia-Pacific region and beyond. Studies on state-of-the-art surgical innovations across the entire spectrum of clinical and experimental surgery are particularly welcome. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance.