Clinical implication of inflammation-based prognostic score and perioperative nutrition control in pancreatic cancer.

Authors

null

Nao Takano

Nagoya University Graduate School of Medicine, Nagoya, Japan

Nao Takano , Suguru Yamada , Tsutomu Fujii , Mitsuru Tashiro , Nobutake Tanaka , Daishi Morimoto , Go Ninomiya , Yukiko Niwa , Hideki Takami , Naoki Iwata , Masamichi Hayashi , Mitsuro Kanda , Chie Tanaka , Daisuke Kobayashi , Goro Nakayama , Hiroyuki Sugimoto , Masahiko Koike , Michitaka Fujiwara , Yasuhiro Kodera

Organizations

Nagoya University Graduate School of Medicine, Nagoya, Japan, Nagoya University, Ama-Gun, Japan, Nagoya University, Nagoya, Japan, Gastroenterological Surgery, Nagoya University, Nagoya City, Japan, gastroenterological Surgery, Nagoya University, Nagoya City, Japan, Nagoya University Hospital, Nagoya City, Japan, Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan, Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan, Department of Gastroenterological Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Japan, Nagoya University, Aichi, Japan

Research Funding

Other

Background: Systemic inflammation and nutrition status are considered to influence survival in cancer patients. A variety of systemic inflammation-based prognostic scores have been explored; however, there has been no study to clarify which score could best reflect survival in resected pancreatic cancer patients. Methods: Between 2002 and 2016, 422 consecutive patients who underwent curative resection of pancreatic cancer were enrolled. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), prognostic index (PI), and prognostic nutritional index (PNI) scores for each patients were calculated. Survival of each score was evaluated, and correlations between the score selected on the basis of the prognostic significance and various clinicopathological factors were analyzed. On the other hand, the nutrition markers (pre-albumin, transferrin, and retinol-binding protein) of 30 patients who received the enteral nutrition during the perioperative period were also evaluated. Results: In the analysis of the GPS, the median survival time (MST) was 29.4 months for score 0, 25.5 for score 1, and 17.7 for score 2 (p< 0.001), and mGPS was also found to be significant (p= 0.003). On the contrary, there were no significance in MST between other scores (NLR, PLR, PI, or PNI). Multivariate analysis revealed that lymph node metastasis, positive peritoneal washing cytology, and a GPS score of 2 were significant prognostic factors. There was also statistically significant correlation between the GPS score and tumor location (head), tumor size ( > 2.0cm), bile duct invasion, and duodenal invasion. In terms of nutrition status, the postoperative nutrition markers of 30 patients managed by enteral nutrition tended to recover earlier than 79 patients managed by intravenous nutrition. Conclusions: Our results demonstrated that the GPS could be an independent predictive marker and was superior to other inflammation-based prognostic scores in patients with resected pancreatic cancer. The results also suggested that perioperative nutrition support and infection control would improve survival of pancreatic cancer patients.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2017 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel and Hepatobiliary Tract

Track

Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 35, 2017 (suppl 4S; abstract 390)

DOI

10.1200/JCO.2017.35.4_suppl.390

Abstract #

390

Poster Bd #

H16

Abstract Disclosures

Similar Abstracts

First Author: Lucy Xiaolu Ma

First Author: Rocío Martín Lozano