Abstract
Background: Preoperative nutritional and immunological patient factors have been found to be associated with prognostic outcomes of malignant tumors; however, the clinical significance of these factors in pancreatic ductal adenocarcinoma (PDAC) remains controversial. Objective: The purpose of this study was to evaluate the prognostic value of nutritional and immunological factors including sarcopenia in predicting survival of patients with PDAC. Methods: Retrospective studies of 156 patients who underwent surgical resection for PDAC between 2007 and 2019 were conducted to investigate the prognostic impact of tumor-related factors and patient-related factors, including Skeletal muscle index (SMI), Visceral adipose tissue accumulation, Glasgow Prognostic Score (GPS), modified GPS, Prognostic Nutritional Index, and neutrophil/lymphocyte ratio. Results: In multivariate analysis, low SMI was an independent factor for OS (HR, 2.82; 95% CI, 1.69-4.71; P < 0.001) and DFS (HR, 1.64 95% CI, 1.02-2.63; P = 0.04). The low SMI group was significantly associated with no adjuvant chemotherapy (P =0.015), BMI (< 22) (P < 0.001), tumor size (>2cm) (P=0.035), Histologic grade (Mod/Poor) (P < 0.001) compared with the high SMI group. Conclusions: Perioperative nutrition therapy and rehabilitation might contribute to improve prognosis in patients with PDAC.
Published Version
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