Detailed Abstract
[BP Oral Presentation 4]
[BP OP 4-3] Oncologic Impact of Preoperative Prognostic Nutritional Index Change in Resected Pancreatic Cancer Following Neoadjuvant Chemotherapy
Kang Hyun KIM1, Chang Moo KANG* 2, 3, Ho Kyoung HWANG2, 3, Woo Jung LEE2, 3
1Yonsei University College of Medicine, Yonsei University College of Medicine, Korea
2Division of HBP Surgery, Department of Surgery, Yonsei University College of Medicine, Korea
3Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, K
Introduction : A variety of studies have focused on the oncologic impact of preoperative prognostic nutritional index (PNI). However, there was no study correlating preoperative PNI change and oncologic outcome of resected pancreatic cancer following neoadjuvant chemotherapy (NAC).
Methods : 110 pancreatic ductal adenocarcinoma patients who underwent NAC followed by surgical resection were retrospectively evaluated. ΔPNI was defined as post-NAC PNI subtracted by pre-NAC PNI. Patients were divided into high ΔPNI group (>-2.25, n=55) and low ΔPNI group (≤-2.25, n=55) according to optimal cut-off value selected using using Contal and O’Quigley’s method. Clinicopathological characteristics including long-term oncologic outcomes, such as overall survival (OS) and disease-free survival (DFS), were compared. In addition, univariate and multivariate analysis were used to identify independent prognostic factors.
Results : High ΔPNI group was found to be related with lower pre-NAC PNI (47.09±4.74 vs 52.01±5.68, p<0.001) and higher post-NAC PNI (50.13±4.80 vs 42.71±7.32, p<0.001) when compared with low ΔPNI group. Furthermore, high ΔPNI group was associated with longer OS compared with low ΔPNI (mean OS: 64.16 months [95% CI: 50.15-78.17] vs. 39.98 months [95% CI: 26.89-53.08], p=0.002). There was no significant difference in DFS (p>0.05). Multivariate analysis revealed that low ΔPNI was an independent risk factor for OS (HR, 3.101; 95% CI, 1.741-5.524; p<0.001), but not for DFS (p>0.05).
Conclusions : Low ΔPNI (≤-2.25) was an independent risk factor for overall survival of resected pancreatic cancer patients following NAC. In preoperative setting, improving PNI can be one of the strategy to improve long-term oncologic outcome. Further study is mandatory.
was observed. N
Methods : 110 pancreatic ductal adenocarcinoma patients who underwent NAC followed by surgical resection were retrospectively evaluated. ΔPNI was defined as post-NAC PNI subtracted by pre-NAC PNI. Patients were divided into high ΔPNI group (>-2.25, n=55) and low ΔPNI group (≤-2.25, n=55) according to optimal cut-off value selected using using Contal and O’Quigley’s method. Clinicopathological characteristics including long-term oncologic outcomes, such as overall survival (OS) and disease-free survival (DFS), were compared. In addition, univariate and multivariate analysis were used to identify independent prognostic factors.
Results : High ΔPNI group was found to be related with lower pre-NAC PNI (47.09±4.74 vs 52.01±5.68, p<0.001) and higher post-NAC PNI (50.13±4.80 vs 42.71±7.32, p<0.001) when compared with low ΔPNI group. Furthermore, high ΔPNI group was associated with longer OS compared with low ΔPNI (mean OS: 64.16 months [95% CI: 50.15-78.17] vs. 39.98 months [95% CI: 26.89-53.08], p=0.002). There was no significant difference in DFS (p>0.05). Multivariate analysis revealed that low ΔPNI was an independent risk factor for OS (HR, 3.101; 95% CI, 1.741-5.524; p<0.001), but not for DFS (p>0.05).
Conclusions : Low ΔPNI (≤-2.25) was an independent risk factor for overall survival of resected pancreatic cancer patients following NAC. In preoperative setting, improving PNI can be one of the strategy to improve long-term oncologic outcome. Further study is mandatory.
was observed. N
SESSION
BP Oral Presentation 4
Room C 4/6/2019 8:44 AM - 8:51 AM