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
3020 - Circulating tumor DNA (ctDNA) analysis depicts mechanisms of resistance and tumor response to BRAF inhibitors in BRAF-mutant non-small cell lung cancer (NSCLC)
Presenter: Sandra Ortiz - Cuaran
Session: Poster Display session 1
Resources:
Abstract
1271 - A large scale prospective concordance study of oncogene driver detection between plasma- and tissue-based NGS analysis in advanced non-small cell lung cancer (NSCLC).
Presenter: Ryo Itotani
Session: Poster Display session 1
Resources:
Abstract
1132 - Biomarker status as a mediator of age-related overall survival (OS) in advanced non-small cell lung cancer (aNSCLC)
Presenter: Aaron Cohen
Session: Poster Display session 1
Resources:
Abstract
1502 - An exploratory analysis of on-treatment ctDNA measurement as a potential surrogate for overall survival for atezolizumab benefit in the OAK Study
Presenter: David Gandara
Session: Poster Display session 1
Resources:
Abstract
3912 - Disease monitoring of EGFR mutation-positive NSCLC patients via circulating tumor DNA
Presenter: Wei Fang Hsu
Session: Poster Display session 1
Resources:
Abstract
3856 - Incidence of T790M in NSCLC patients progressed to gefitinib, erlotinib, and afatinib: a study on circulating tumor DNA
Presenter: Romano Danesi
Session: Poster Display session 1
Resources:
Abstract
1330 - Folate receptor-positive circulating tumor cells as a predictive biomarker for the efficacy of first-line pemetrexed-based therapy in patients with non-squamous non-small cell lung cancer
Presenter: Xiaoxia Chen
Session: Poster Display session 1
Resources:
Abstract
3512 - Carcinoembryonic Antigen of Cerebrospinal Fluid Predict Prognosis of Leptomeningeal Metastasis from Non-Small Cell Lung Cancer
Presenter: Junjie Zhen
Session: Poster Display session 1
Resources:
Abstract
3852 - Liquid biopsy in clinical pratice of Non-Small-Cell-Lung Cancer (NSCLC): a multi-institutional experience
Presenter: Giovanna De Maglio
Session: Poster Display session 1
Resources:
Abstract
1205 - A Phase III Study Comparing SB8, a Proposed Bevacizumab Biosimilar, and Reference Bevacizumab in Patients with Metastatic or Recurrent Non-squamous NSCLC
Presenter: Martin Reck
Session: Poster Display session 1
Resources:
Abstract