Abstract 3972
Background
Nutritional derangements are common hallmarks of PDAC. Their early detection and management are usually overlooked in routine practice. The aim of this study was to explore the prognostic value of nutritional status in patients (pts) undergoing surgery for PDAC.
Methods
We prospectively studied 73 non-consecutive pts submitted to surgery for PDAC from November 2015 to January 2018 at General and Pancreatic Surgery Unit, Pancreas Institute, University Hospital of Verona. Nutritional Risk Screening (NRS) 2002 was used to evaluate the nutritional risk. Body composition was assessed using Bioelectrical Impedance Vector Analysis (BIVA) the day before the scheduled surgery. Clinical, pathological and nutritional data were correlated to disease-free/overall survival (DFS/OS) using a Cox and logistic regression model. Kaplan-Meier curves were compared with Log-Rank.
Results
The median age was 65 years [range 37-81], 41 pts were male (56.2%) and 32 were female (43.8%). Median follow-up was 11 months [range 1-40]. The majority (80.8%) were at risk of malnutrition (NRS-2002≥3), despite median BMI was 23.9 kg/m2. At multivariate analysis, stage (HR 4.30, 95% CI 1.03-17.92, p = 0.045), NRS-2002 (HR 6.51, 95% CI 1.39-30.38, p = 0.017), fat-free mass (FFM) (HR 1.08, 95% CI 1.02-1.14, p = 0.013) were significant independent predictors for OS. Particularly, pts with preoperative NRS-2002 ≤3 had significantly longer 2-year OS than those with NRS-2002 >3 (94% vs 75%, p = 0.02). Twenty-four pts (32.9%) were treated with neoadjuvant therapy. NRS-2002 was significantly higher in this subset of pts (p = 0.026), with a significant difference according to chemotherapy regimens (Folfirinox vs. Gemcitabine/Nab-paclitaxel) (p = 0.035). In pts treated with adjuvant chemotherapy (n = 33, 45.2%) FFM correlated with worse DSF and OS (p = 0.039 and p = 0.039, respectively).
Conclusions
Our analysis suggests that preoperative malnutrition has a detrimental impact on OS in PDAC. Therefore, preoperative nutritional screening and, possibly, targeted nutritional intervention may improve outcomes in resectable PDAC pts, particularly in those who are candidate to neoadjuvant therapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M. Milella: Honoraria (self): Pfizer, EUSA Pharma, AstraZeneca. All other authors have declared no conflicts of interest.
Resources from the same session
4085 - A Phase 1, Open-Label, Dose-Escalation Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Antitumor Activity of ADCT-601 in Patients with Advanced Solid Tumors
Presenter: Anthony Tolcher
Session: Poster Display session 1
Resources:
Abstract
1054 - Safety, efficacy, and pharmacokinetic (PK) profile of cosibelimab, an anti‐PD‐L1 antibody, in patients (pts) with advanced cancers
Presenter: Philip Clingan
Session: Poster Display session 1
Resources:
Abstract
4264 - A Phase I study of tinostamustine in patients (pts) with advanced solid tumours
Presenter: Alain Mita
Session: Poster Display session 1
Resources:
Abstract
3811 - Lurbinectedin (LUR) in combination with Irinotecan (IRI) in patients (pts) with advanced solid tumors
Presenter: Santiago Ponce Aix
Session: Poster Display session 1
Resources:
Abstract
1311 - A phase I study of varlitinib (VAR; ASLAN001) an oral pan-HER tyrosine kinase inhibitor (TKI) combined with mFOLFIRI chemotherapy in advanced solid tumors
Presenter: Aaron Tan
Session: Poster Display session 1
Resources:
Abstract
3482 - Phase I study of lapatinib and trametinib in patients with KRAS mutant colorectal, non-small cell lung and pancreatic cancer
Presenter: Sanne Huijberts
Session: Poster Display session 1
Resources:
Abstract
4749 - Pharmacokinetic (PK) and updated survival data from the Canadian Cancer Trials Group IND.226 study of durvalumab ± tremelimumab in combination with platinum-doublet chemotherapy
Presenter: Desiree Hao
Session: Poster Display session 1
Resources:
Abstract
4530 - A Phase 2a clinical trial combining ALRN-6924 and palbociclib for the treatment of patients with tumors harboring wild-type p53 and MDM2 amplification or MDM2/CDK4 co-amplification
Presenter: Funda Meric-Bernstam
Session: Poster Display session 1
Resources:
Abstract
4280 - Updated Efficacy and Safety of Entrectinib in Patients with NTRK Fusion-Positive Tumors: Integrated Analysis of STARTRK-2, STARTRK-1 and ALKA-372-001
Presenter: Christian Rolfo
Session: Poster Display session 1
Resources:
Abstract
6144 - An international randomized cross-over bio-equivalence study of oral paclitaxel + HM30181 compared with weekly intravenous (IV) paclitaxel in patients with advanced solid tumors
Presenter: Christopher Jackson
Session: Poster Display session 1
Resources:
Abstract