The Relationship between Nutritional Status and Body Composition with Clinical Parameters, Tumor Stage, CA19-9, CEA Levels in Patients with Pancreatic and Periampullary Tumors.

Aneta Jachnis,Maciej Tomasz Słodkowski

doi:10.3390/curroncol28060406

Abstract

Recent studies have obtained inadequate data on the association between nutritional status, body composition, clinical parameters and tumor stage in patients withpancreatic and periampullary tumors. The purpose of this study was to assess the relationship between nutritional status (NS), body composition (BC) and selected clinical parameters in patients with pancreatic and periampullary cancer, as well as describe the differences between resection and non-resection groups. This is a prospective study of 76 patients with pancreatic and periampullary tumors. We evaluated NS, BMI, body mass loss (BML) and albumin, total protein, CRP, CEA, CA19-9, lipase, amylase, tumor stage, and BC using bioelectrical impedance (BIA). All subjects were divided into resection (n = 59) and non-resection (n = 17) groups. The non-resection group had a worse NS, as well as increased amylase and WBC, compared to the resection. The selected parameters of BC corresponded to BML albumin, TP, NS, age, BMI, Karnofsky, RBC, HCT and HGB. No associations were found between BC with tumor size, CRP, CA19-9, and CEA. We recorded the relationship between metastasis and NRS, as well as tumor size with SGA. The percentage of BML was positively correlated with age and CRP but negatively correlated with RBC, HGB, HCT and anthropometric measurements. We found many statistical correlations with NS and selected parameters, as well as differences between the resection and non-resection group. The detection of early prognostic factors of nutritional impairments would improve the quality of life and reduce the rate of postoperative complications.

Highlights

Periampullary carcinoma and pancreatic cancer have generally poor prognoses
In addition to the above results, the analysis showed statistically significant differences only in the mean level of amylase (p = 0.046) and white blood cells WBC (p = 0.007)—both parameters were greater in the resection group and red blood cells RBC, which were higher in the non-resection group (p = 0.032)
We found a positive correlation of body mass loss% with icw, 50 Hz impedance, C-reactive protein (CRP), and age, as well as a significant negative correlation with fat_kg, tbw_lt, ecw%, ecw/icw, arm, calf, body mass index (BMI), Karnofsky score, RBC, HGB, and HCT

Summary

Introduction

Periampullary carcinoma and pancreatic cancer have generally poor prognoses. Pancreatic cancer (PC) presents a high postoperative complication rate, high mortality, and a low survival rate. The 5-year relative survival in patients with PC is 10.8% (depending on the stage of diagnosis) and increases to 18% in pancreatic tumors and 45% in ampullary carcinoma in the case of a resectable tumor after resection [1,2]. Surgical resection is the only chance for a potential cure. The standard treatment for both pancreatic cancers located at the head of the pancreas and periampullary tumors is pancreatoduodenectomy (PD) and distal or total pancreatectomy for other cancers in the pancreas. Many patients report difficulties eating and gastrointestinal complaints during the perioperative period, which lead to nutritional status impairments [3]

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