Abstract 1856P
Background
Loss of pancreatic parenchyma and/or the obstruction of the main duct may cause pancreatic exocrine insufficiency (PEI), resulting in maldigestion and malabsorption of nutrients. Despite the importance of treating PEI and malnutrition, evidence suggests that their early detection and management are usually overlooked in clinical routine. The current analysis aims to investigate the use of PERT and its effects on survival in patients (pts) affected by advanced PDAC undergoing chemotherapy.
Methods
A retrospective analysis was conducted on non-consecutive pts with advanced pathologically confirmed PDAC. All pts were treated with Gemcitabine plus Nab Paclitaxel-based first-line chemotherapy at two academic medical institutions from March 2015 to October 2018. Descriptive statistics was adopted. Data were correlated with overall survival (OS) using a Cox regression model. Kaplan-Meier curves were compared with Log-Rank test.
Results
Data from 110 pts (57 males [51.8%], 53 females [48.2%]) were gathered (median age 65 years [range 37-81], with a median follow-up of 12 months (range 2-55). More than 65% had symptoms that could be related to malabsorption, like abdominal discomfort, bloating and steatorrhea. PERT was administered in 55 pts (50%), with no significant differences in baseline characteristics (age, gender, surgery, stage, weight loss, Performance Status) with those who did not receive PERT. Median OS for the entire group was 12 months (95%CI 9-15). At multivariate analysis, surgery of the primary (HR 3.12, 95% CI 1.51-6.44, p = 0.02) and PERT (HR 2.08, 95% CI 1.26-3.45, p = 0.004) were independent significant predictors of OS. Particularly, pts who received PERT had significantly longer 1-year OS (61.8% vs 32.5%, p = 0.0001).
Conclusions
Our analysis suggests that previous surgery and PERT are independently associated with survival outcomes in pts with advanced PDAC receiving first-line chemotherapy. However, patterns of PEI assessment and PERT prescription are inconsistent and specific algorithms should be implemented, in light of the potential impact on survival and QoL.
Clinical trial identification
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.