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
4615 - Proteomic Profiling Identifies Molecular Basis of Adverse Event to BPM31510 Exposure: Rationale for Comprehensive Molecular Pharmacodynamics (PD) in Phase 1 Clinical Trial Design
Presenter: Vivek Subbiah
Session: Poster Display session 1
Resources:
Abstract
5052 - Identification of first-in-class, naturally occurring LAG3 checkpoint inhibitor
Presenter: Gennady Bratslavsky
Session: Poster Display session 1
Resources:
Abstract
5336 - Are Epigenetic therapies modifying sensitivity to conventional chemotherapy?
Presenter: Alexandra Bizot
Session: Poster Display session 1
Resources:
Abstract
5739 - Oncogenic mutations at the dimer interface of EGFR lead to formation of covalent homo-dimers and allosteric activation of the kinase domain: A mechanism which alters the selectivity profile of oncogenic EGFR.
Presenter: Elizabeth Buck
Session: Poster Display session 1
Resources:
Abstract
5492 - Basic selective estrogen receptor degraders (B-SERDs) in combination with novel BET inhibitors in ER+ breast cancer
Presenter: Rui Xiong
Session: Poster Display session 1
Resources:
Abstract
5965 - EPI-7386 is a novel N-terminal domain androgen receptor inhibitor for the treatment of prostate cancer
Presenter: Ronan Le Moigne
Session: Poster Display session 1
Resources:
Abstract
3582 - AVID200 neutralizes TGF-beta1 and -beta3, the principal immunosuppressive TGF-beta isoforms overexpressed by tumors, and sensitizes tumors to immune checkpoint inhibitors.
Presenter: Tina Gruosso
Session: Poster Display session 1
Resources:
Abstract
1996 - High NAMPT expression and anti-tumor activity of NAMPT inhibitor in adult T-cell leukemia/lymphoma
Presenter: Tomohiro Kozako
Session: Poster Display session 1
Resources:
Abstract
4307 - TPX-0046 is a novel and potent RET/SRC inhibitor for RET-driven cancers
Presenter: Alexander Drilon
Session: Poster Display session 1
Resources:
Abstract
4869 - In Vivo Evaluation of Cisplatin-loaded PEG-PCL Block Copolymeric Nanoparticles for Anticancer Drug Delivery
Presenter: Yingtzu Yen
Session: Poster Display session 1
Resources:
Abstract