Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection
Abstract Purpose Reports on the association of perioperative nutritional and inflammatory status with the clinical course of adjuvant chemotherapy did not include neoadjuvant chemotherapy. We aimed to clarify the mechanism by which perioperative nutritional and inflammatory status affect the clinica...
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BMC
2024-11-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-024-13244-z |
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| author | Shinnosuke Kawahara Toru Aoyama Masaaki Murakawa Rei Kanemoto Daishi Takahashi Yuto Kamioka Itaru Hashimoto Yukio Maezawa Satoshi Kobayashi Makoto Ueno Naoto Yamamoto Takashi Oshima Norio Yukawa Yasushi Rino Aya Saito Soichiro Morinaga |
| author_facet | Shinnosuke Kawahara Toru Aoyama Masaaki Murakawa Rei Kanemoto Daishi Takahashi Yuto Kamioka Itaru Hashimoto Yukio Maezawa Satoshi Kobayashi Makoto Ueno Naoto Yamamoto Takashi Oshima Norio Yukawa Yasushi Rino Aya Saito Soichiro Morinaga |
| author_sort | Shinnosuke Kawahara |
| collection | DOAJ |
| description | Abstract Purpose Reports on the association of perioperative nutritional and inflammatory status with the clinical course of adjuvant chemotherapy did not include neoadjuvant chemotherapy. We aimed to clarify the mechanism by which perioperative nutritional and inflammatory status affect the clinical course of postoperative adjuvant chemotherapy in patients with pancreatic cancer. Methods We enrolled 123 patients with pancreatic cancer retrospectively who underwent surgical resection with neoadjuvant and S-1 adjuvant chemotherapy between January 2013 and December 2022. The duration of continuing S-1 treatment and the continuation rates at 3 and 6 months after initiating adjuvant chemotherapy were calculated using the Kaplan–Meier method. The log-rank test was used to evaluate statistical differences between the high and low prognostic nutritional index (PNI) groups. Univariable and multivariable analyses were performed to determine the risk factors for continuing S-1 adjuvant chemotherapy. Results The optimal cut-off value for preoperative PNI was 45. Preoperative PNI was an independent risk factor for continuing S-1 adjuvant chemotherapy in patients who underwent perioperative adjuvant chemotherapy and surgical resection (hazard ratio = 2.435, 95% confidence interval = 1.229 − 4.824, p = 0.011). Low PNI was associated with lower S-1completion (p = 0.02) and higher S-1 withdrawal (p = 0.031). Additionally, the preoperative PNI status affected ≥ grade 2 adverse events caused by adjuvant chemotherapy (p < 0.001). Conclusion Preoperative PNI affected adjuvant chemotherapy continuation and related adverse events in patients who underwent neoadjuvant chemotherapy and curative resection. Additional perioperative anti-inflammatory management and nutritional support may be required to improve the clinical course of postoperative adjuvant chemotherapy and patient survival. |
| format | Article |
| id | doaj-art-eaecc4bcd5e4445babf0537a72df9e16 |
| institution | OA Journals |
| issn | 1471-2407 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-eaecc4bcd5e4445babf0537a72df9e162025-08-20T02:08:16ZengBMCBMC Cancer1471-24072024-11-012411910.1186/s12885-024-13244-zPrognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resectionShinnosuke Kawahara0Toru Aoyama1Masaaki Murakawa2Rei Kanemoto3Daishi Takahashi4Yuto Kamioka5Itaru Hashimoto6Yukio Maezawa7Satoshi Kobayashi8Makoto Ueno9Naoto Yamamoto10Takashi Oshima11Norio Yukawa12Yasushi Rino13Aya Saito14Soichiro Morinaga15Department of Gastrointestinal Surgery, Kanagawa Cancer CenterDepartment of Surgery, Yokohama City UniversityDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterDepartment of Surgery, Yokohama City UniversityDepartment of Surgery, Yokohama City UniversityDepartment of Gastroenterology, Kanagawa Cancer CenterDepartment of Gastroenterology, Kanagawa Cancer CenterDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterDepartment of Surgery, Yokohama City UniversityDepartment of Surgery, Yokohama City UniversityDepartment of Surgery, Yokohama City UniversityDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterAbstract Purpose Reports on the association of perioperative nutritional and inflammatory status with the clinical course of adjuvant chemotherapy did not include neoadjuvant chemotherapy. We aimed to clarify the mechanism by which perioperative nutritional and inflammatory status affect the clinical course of postoperative adjuvant chemotherapy in patients with pancreatic cancer. Methods We enrolled 123 patients with pancreatic cancer retrospectively who underwent surgical resection with neoadjuvant and S-1 adjuvant chemotherapy between January 2013 and December 2022. The duration of continuing S-1 treatment and the continuation rates at 3 and 6 months after initiating adjuvant chemotherapy were calculated using the Kaplan–Meier method. The log-rank test was used to evaluate statistical differences between the high and low prognostic nutritional index (PNI) groups. Univariable and multivariable analyses were performed to determine the risk factors for continuing S-1 adjuvant chemotherapy. Results The optimal cut-off value for preoperative PNI was 45. Preoperative PNI was an independent risk factor for continuing S-1 adjuvant chemotherapy in patients who underwent perioperative adjuvant chemotherapy and surgical resection (hazard ratio = 2.435, 95% confidence interval = 1.229 − 4.824, p = 0.011). Low PNI was associated with lower S-1completion (p = 0.02) and higher S-1 withdrawal (p = 0.031). Additionally, the preoperative PNI status affected ≥ grade 2 adverse events caused by adjuvant chemotherapy (p < 0.001). Conclusion Preoperative PNI affected adjuvant chemotherapy continuation and related adverse events in patients who underwent neoadjuvant chemotherapy and curative resection. Additional perioperative anti-inflammatory management and nutritional support may be required to improve the clinical course of postoperative adjuvant chemotherapy and patient survival.https://doi.org/10.1186/s12885-024-13244-zPancreatic cancerPrognostic nutritional indexAdjuvant chemotherapyS-1Risk factor |
| spellingShingle | Shinnosuke Kawahara Toru Aoyama Masaaki Murakawa Rei Kanemoto Daishi Takahashi Yuto Kamioka Itaru Hashimoto Yukio Maezawa Satoshi Kobayashi Makoto Ueno Naoto Yamamoto Takashi Oshima Norio Yukawa Yasushi Rino Aya Saito Soichiro Morinaga Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection BMC Cancer Pancreatic cancer Prognostic nutritional index Adjuvant chemotherapy S-1 Risk factor |
| title | Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection |
| title_full | Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection |
| title_fullStr | Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection |
| title_full_unstemmed | Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection |
| title_short | Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection |
| title_sort | prognostic nutritional index is an independent risk factor for continuing s 1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection |
| topic | Pancreatic cancer Prognostic nutritional index Adjuvant chemotherapy S-1 Risk factor |
| url | https://doi.org/10.1186/s12885-024-13244-z |
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