Prognostic impact of early nutritional support in patients affected by locally advanced and metastatic pancreatic ductal adenocarcinoma undergoing chemotherapy

Ilaria Trestini, Luisa Carbognin, Isabella Sperduti, Clelia Bonaiuto, Alessandra Auriemma, Davide Melisi, Lisa Salvatore, Emilio Bria, Giampaolo Tortora

Research output: Contribution to journalArticle

Abstract

Background/objectives: The aim of this analysis was to determine the risk of malnutrition and the prognostic value of nutritional intervention in patients affected by pancreatic ductal adenocarcinoma (PDAC) undergoing chemotherapy. Subjects/methods: Clinical–pathological and nutritional data were correlated with overall survival (OS) using a Cox model. Nutritional status was determined by Malnutrition Universal Screening Tool (MUST), body mass index, weight loss in the past 6 months, presence of nutrition-related symptoms, and current energy intake. Nutritional intervention included appropriate individual dietary counseling. Results: Data from 109 patients were gathered (median age 63 years). The majority of patients (64.2%) presented a MUST value of ≥ 2, corresponding to a high risk of malnutrition. At multivariate analysis for OS in locally advanced and metastatic PDAC patients, the time between the diagnosis and the nutritional intervention (HR 2.22, p = 0.017), the performance status (HR 1.38, p = 0.075), the surgery of the primary (HR 5.89, p = 0.005), and the response to the first line (HR 5.9, p = 0.03) were independent significant predictors of outcome. Furthermore, a weight gain > 2% from the baseline weight was correlated with the time between the diagnosis and the nutritional intervention (p = 0.021): in patients receiving a nutritional support within 3 months from diagnosis, a 2% weight gain was associated with a 2-year OS benefit (50.3% vs. 33.0%, p = 0.04). Conclusions: This analysis suggests that the early nutritional support may contribute to influence the prognosis of patients affected by advanced PDAC undergoing chemotherapy.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalEuropean Journal of Clinical Nutrition
DOIs
Publication statusAccepted/In press - Mar 26 2018

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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