Associations between Nutritional and Immune Status and Clinicopathologic Factors in Patients with Pancreatic Cancer: A Comprehensive Analysis

Jabłońska, Beata; Pawlicki, Krzysztof; Mrowiec, Sławomir

doi:10.3390/cancers13205041

Cited by 20 publications

(22 citation statements)

References 44 publications

(103 reference statements)

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“… 32 , 33 Furthermore, patients with a systemic inflammatory state and impaired nutritional conditions showed worse DFS and OS, as already reported in patients with earlier-stage PDAC. 26 , 34 In particular, the combination of lymphocytopenia and hypoalbuminemia indicates immunosuppression and compromised immune-nutritional status, which may lead to reduced adjuvant chemotherapy tolerance and earlier recurrence. 35 While poor nutritional status following first-line chemotherapy can be interpreted as a marker of a biologically aggressive disease, prehabilitation programs in responders could be implemented to address nutritional issues and improve the functional capability of a patient.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation-based prognostic scores known to have a role in cancer progression, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet × neutrophil/lymphocyte count (SII), and prognostic nutrition index (PNI; 10 × s-albumin g/dL + 0.005 × total lymphocyte in peripheral blood/mm 3 ), were calculated at baseline and before surgery. 26 Pathologic data included residual tumor evaluation, nodal status, tumor stage per American Joint Committee on Cancer (AJCC) criteria, 27 margin status, and vascular and perineural infiltration. Follow-up details included date and first site of recurrence, recurrence treatment, and date of death.…”

Section: Methodsmentioning

confidence: 99%

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Prognostic Factors After Pancreatectomy for Pancreatic Cancer Initially Metastatic to the Liver

et al. 2022

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Background Resection of initially oligometastatic pancreatic ductal adenocarcinoma (PDAC) following response to first-line chemotherapy is controversial. We herein updated a previous case series to investigate the oncologic outcomes and preoperative factors that could drive the decision-making process. Methods This retrospective analysis was limited to patients with liver-only synchronous metastases who experienced complete regression of the metastatic component and underwent pancreatectomy between October 2008 and July 2020 at two high-volume institutions. Clinical-pathologic variables were captured, and inflammation-based prognostic scores were calculated. Recurrence and survival analyses were performed using standard statistical methods. Results Overall, 52 patients were included. FOLFIRINOX was the most employed chemotherapy regimen (63.5%). Post-treatment tumor size, serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) were significantly decreased relative to baseline evaluation. The median time from diagnosis to pancreatectomy was 10.2 months, while the median time from chemotherapy completion to pancreatectomy was 2 months. Major postoperative complications occurred in 26.9% of patients, while postoperative mortality was nil. The median disease-free survival (DFS) and overall survival (OS) from pancreatectomy were 16.5 and 23.0 months, respectively, and the median OS from diagnosis was 37.2 months. At multivariable analysis, vascular resection, operative time, prognostic nutrition index (PNI) and neutrophil-to-lymphocyte ratio (NLR) were associated with OS. Operative time, platelet × neutrophil/lymphocyte count (SII), and PNI were associated with DFS. Conclusions We confirm promising outcomes of selected patients who underwent pancreatectomy following downstaging of liver metastases. The absence of vascular involvement of the primary tumor, good nutritional status, and low inflammatory index scores could be useful to select candidates for resection.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Prognostic Factors After Pancreatectomy for Pancreatic Cancer Initially Metastatic to the Liver

et al. 2022

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“…A prospective study [ 33 ] collected 355 patients who underwent PD and evaluated nutritional status by mini nutrition assessment (MNA), and compared with well-nourished patients, patients with nutritional issues showed a higher risk of complications. Additionally, the nutrition status assessed by the PG-SGA [ 34 ] and NRS-2002 [ 35 ] was also closely related to the postoperative complications of patients with ampullary carcinoma after PD. In contrast, Probst et al studied 12 nutritional assessment tools and found that none of these tools defined malnutrition as relevant to complications after pancreatic surgery [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Phase Angle, Nutrition Status, and Complications in Patients with Pancreatic Head Cancer

Zhou

Shi

Zhao

et al. 2022

IJERPH

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Phase angle (PhA), a bioimpedance parameter, is used to assess the nutrition status and body composition of patients. Patients with pancreatic head cancer often present with body composition changes that relate to adverse outcomes. PhA may be useful to evaluate prognosis in these patients, but data are deficient. We aim to explore the effects of PhA on nutrition evaluation and short-term outcome prediction in these patients. This prospective study included 49 participants with pancreatic head cancer who underwent pancreaticoduodenectomy (PD). All participants’ nutritional status and postoperative complications were assessed using nutrition assessment tools and the Clavien–Dindo classification method, respectively. Spearman correlation analyses were used to evaluate the association between PhA, nutrition status, and postoperative complications. ROC curves were generated to evaluate the ability of PhA to predict malnutrition and complications and to determine the cutoff value. The PhA values of the nutritional risk group and the malnourished group were significantly lower than those of the well-nourished group (p < 0.05). PhA positively correlated with patients’ nutrition status. Nineteen patients had postoperative complications, and the PhA value of the complication group was significantly lower than that of the non-complication group (4.94 vs. 5.47, p = 0.013). ROC curves showed that the cutoff point of PhA to predict malnutrition was 5.45 (AUC: 0.744), and the cutoff point of PhA to predict postoperative complications was 5.35 (AUC: 0.717). Our study indicates that PhA was associated with nutrition status and could be considered a nutrition assessment tool for pancreatic head cancer patients and predict the postoperative complications of these patients who have undergone PD.

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“…Some scholars have reported that a low PNI is associated with pulmonary tuberculosis cavities and death ( Nakao et al., 2019 ). Studies on the prognosis of pancreatic cancer have found that serum concentrations of total protein and albumin are significantly reduced in patients with low PNI ( Jabłońska et al., 2021 ). We grouped patients according to the mean PNI value of 45 and found that the low PNI group had significantly lower serum total protein and albumin concentrations and higher NRS scores, confirming that PNI can also be used to assess nutritional risk in tuberculosis patients.…”

Section: Discussionmentioning

confidence: 99%

Associations between nutritional and immune status and clinicopathologic factors in patients with tuberculosis: A comprehensive analysis

Liu

Tang

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectiveThis study was designed to assess and analyze nutritional status (NS) and immune status in patients with tuberculosis.MethodsA retrospective analysis was conducted on 93 TB patients hospitalized in the tuberculosis ward of the West China Hospital of Sichuan University. Subgroup comparisons were made according to age (<65 years and ≥65 years), nutritional risk score 2002 (NRS 2002 <3 and ≥3), tuberculosis location [pulmonary tuberculosis and extrapulmonary tuberculosis (including pulmonary tuberculosis complicated with extrapulmonary tuberculosis)], and prognostic nutrition index (PNI) (<45 vs ≥45).ResultsSignificantly increased weight loss was associated with extrapulmonary tuberculosis (P =0.0010). Serum albumin (P =0.0214), total lymphocyte count (P = 0.0009) and PNI (P = 0.0033) were significantly decreased in older patients. Neutrophils/lymphocytes (NLR) (P =0.0002), monocytes/lymphocytes (MLR) (P < 0.0001), and platelets/lymphocytes (PLR) (P =0.0107) were higher. According to NRS 2002, higher nutritional risk was associated with lower body weight and body mass index (BMI) (P < 0.0001), higher weight loss (P = 0.0012), longer duration of hospitalization (P =0.0100), lower serum albumin level and hemoglobin concentration (P <0.01), lower creatinine level, and lower PNI (P < 0.01). 0.0001), lower total lymphocyte count (P = 0.0004), higher neutrophil and monocyte counts (P <0.05), and higher NLR (P = 0.0002), MLR (P = 0.0006), and PLR (P = 0.0156). Lower PNI was associated with lower body weight (P = 0.0001) and BMI (P =0.0074), lower total protein, albumin, and hemoglobin concentrations (P < 0.0001), and lower total lymphocyte count (P < 0.0001) and creatinine levels (P = 0.0336), higher age (P =0.0002) and NRS 2002 score, P < 0.0001), longer hos-pital stay (P = 0.0003), higher neutrophil count (P = 0.0042), and NLR, MLR, and PLR (P <0.0001) were significantly correlated. In multivariate logistic regression analysis, weight loss (OR: 0.209, 95% CI: 0.060-0.722; p =0.013) was significantly associated with higher nutritional risk (NRS 2002≥3). In multiple linear regression analysis, the NRS 2002 score was higher (B=2.018; p =0.023), and extrapulmonary tuberculosis (B=-6.205; p =0.007) was linked with a longer duration of hos-pitalization.ConclusionsOlder tuberculosis patients are at nutritional risk, and older patients (≥65 years old) need to pay attention to nutritional monitoring and intervention. Older TB patients and those at risk of malnutrition have increased immune ratio and impaired immune function. Management of TB patients using basic diagnostic tools to assess nutritional and immune status and calculate PNI and immunological indexes (NLR, MLR, PLR) to improve treatment outcomes.

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Associations between Nutritional and Immune Status and Clinicopathologic Factors in Patients with Pancreatic Cancer: A Comprehensive Analysis

Cited by 20 publications

References 44 publications

Prognostic Factors After Pancreatectomy for Pancreatic Cancer Initially Metastatic to the Liver

Prognostic Factors After Pancreatectomy for Pancreatic Cancer Initially Metastatic to the Liver

The Relationship between Phase Angle, Nutrition Status, and Complications in Patients with Pancreatic Head Cancer

Associations between nutritional and immune status and clinicopathologic factors in patients with tuberculosis: A comprehensive analysis

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