Abstract 253P
Background
Reports on the association of perioperative nutritional and inflammatory status with the clinical course of adjuvant chemotherapy did not include neoadjuvant chemotherapy. We aimed to clarify the mechanism by which perioperative nutritional and inflammatory status affect the clinical course of postoperative adjuvant chemotherapy in patients with pancreatic cancer.
Methods
We enrolled 123 patients with pancreatic cancer retrospectively who underwent surgical resection with neoadjuvant and S-1 adjuvant chemotherapy betweenJanuary 2013 and December 2022. The duration of continuing S-1 treatment and the continuation rates at 3 and 6 months after initiating adjuvant chemotherapy were calculated using the Kaplan–Meier method. The log-rank test was used to evaluate statistical differences between the high and low prognostic nutritional index (PNI) groups. Univariate and multivariate analyses were performed to determine the risk factors for continuing S-1 adjuvant chemotherapy.
Results
The optimal cut-off value for preoperative PNI was 45. Preoperative PNI was an independent risk factor for continuing S-1 adjuvant chemotherapy in patients who underwent perioperative adjuvant chemotherapy and surgical resection (hazard ratio =2.435, 95% confidence interval= 1.229−4.824, p=0.011). Low PNI was associated with lower S-1completion (p=0.02) and higher S-1 withdrawal (p=0.031). Additionally, the preoperative PNI status affected ≥grade 2 adverse events caused by adjuvant chemotherapy (p<0.001).
Conclusions
Preoperative PNI affected adjuvant chemotherapy continuation and related adverse events in patients who underwent neoadjuvant chemotherapy and curative resection. Additional perioperative anti-inflammatory management and nutritional support may be required to improve the clinical course of postoperative adjuvant chemotherapy and patient survival.
Clinical trial identification
All protocols were approved by the Ethics Committee of Kanagawa Cancer Center (approval number: 2023 epidemiologic study-169).
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.