Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer
Background: Adjuvant chemotherapy is a standard therapeutic option for resected pancreatic cancer. However, the risk factors for incompletion of adjuvant chemotherapy remain unclear. Methods: We retrospectively reviewed the medical records of 72 patients who underwent radical pancreatectomy and rece...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958424024849 |
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| author | Hiromitsu Maehira Haruki Mori Nobuhito Nitta Takeru Maekawa Yusuke Nishina Hajime Ishikawa Katsushi Takebayashi Sachiko Kaida Toru Miyake Masaji Tani |
| author_facet | Hiromitsu Maehira Haruki Mori Nobuhito Nitta Takeru Maekawa Yusuke Nishina Hajime Ishikawa Katsushi Takebayashi Sachiko Kaida Toru Miyake Masaji Tani |
| author_sort | Hiromitsu Maehira |
| collection | DOAJ |
| description | Background: Adjuvant chemotherapy is a standard therapeutic option for resected pancreatic cancer. However, the risk factors for incompletion of adjuvant chemotherapy remain unclear. Methods: We retrospectively reviewed the medical records of 72 patients who underwent radical pancreatectomy and received S-1 adjuvant chemotherapy for pancreatic cancer. The patients were assigned to two groups according to their completion or incompletion of adjuvant chemotherapy. We compared the perioperative skeletal muscle mass index (SMI) and nutritional status using prognostic nutritional index (PNI) between the two groups. Results: The completion and incompletion groups included 46 (64 %) and 26 (36 %) patients, respectively. Overall survival was shorter in the incompletion group than in the completion group (median survival time, 20.2 months vs. 42.0 months; log-rank, p = 0.018). Decreasing rate of PNI (12.7 % vs. 0.2 %, p = 0.010) and decreasing rate of SMI (26.9 % vs. 12.5 %, p = 0.001) were significantly larger in the incompletion group than in the completion group. Multivariate analysis showed that decreasing rate of PNI (p = 0.016), decreasing rate of SMI (p = 0.013), and old age (p = 0.049) were independent risk factors for incompletion of S-1 adjuvant chemotherapy. Regarding the time-series variations, PNI improved from 1 to 3 months after pancreatectomy in the completion group (p = 0.006). Furthermore, the decreasing slope of SMI was stronger in the incompletion group. Conclusion: Postoperative decrease of PNI and SMI is associated with the incompletion of S-1 adjuvant chemotherapy. |
| format | Article |
| id | doaj-art-f3496d4cfe3a492980de7af2f390f027 |
| institution | Kabale University |
| issn | 1015-9584 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj-art-f3496d4cfe3a492980de7af2f390f0272025-01-30T05:13:43ZengElsevierAsian Journal of Surgery1015-95842025-02-0148210021009Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancerHiromitsu Maehira0Haruki Mori1Nobuhito Nitta2Takeru Maekawa3Yusuke Nishina4Hajime Ishikawa5Katsushi Takebayashi6Sachiko Kaida7Toru Miyake8Masaji Tani9Corresponding author. Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu-shi, Shiga, 520-2192, Japan.; Department of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanDepartment of Surgery, Shiga University of Medical Science, Shiga, JapanBackground: Adjuvant chemotherapy is a standard therapeutic option for resected pancreatic cancer. However, the risk factors for incompletion of adjuvant chemotherapy remain unclear. Methods: We retrospectively reviewed the medical records of 72 patients who underwent radical pancreatectomy and received S-1 adjuvant chemotherapy for pancreatic cancer. The patients were assigned to two groups according to their completion or incompletion of adjuvant chemotherapy. We compared the perioperative skeletal muscle mass index (SMI) and nutritional status using prognostic nutritional index (PNI) between the two groups. Results: The completion and incompletion groups included 46 (64 %) and 26 (36 %) patients, respectively. Overall survival was shorter in the incompletion group than in the completion group (median survival time, 20.2 months vs. 42.0 months; log-rank, p = 0.018). Decreasing rate of PNI (12.7 % vs. 0.2 %, p = 0.010) and decreasing rate of SMI (26.9 % vs. 12.5 %, p = 0.001) were significantly larger in the incompletion group than in the completion group. Multivariate analysis showed that decreasing rate of PNI (p = 0.016), decreasing rate of SMI (p = 0.013), and old age (p = 0.049) were independent risk factors for incompletion of S-1 adjuvant chemotherapy. Regarding the time-series variations, PNI improved from 1 to 3 months after pancreatectomy in the completion group (p = 0.006). Furthermore, the decreasing slope of SMI was stronger in the incompletion group. Conclusion: Postoperative decrease of PNI and SMI is associated with the incompletion of S-1 adjuvant chemotherapy.http://www.sciencedirect.com/science/article/pii/S1015958424024849Adjuvant chemotherapyPancreatic cancerPrognostic nutritional indexS-1Skeletal muscle mass index |
| spellingShingle | Hiromitsu Maehira Haruki Mori Nobuhito Nitta Takeru Maekawa Yusuke Nishina Hajime Ishikawa Katsushi Takebayashi Sachiko Kaida Toru Miyake Masaji Tani Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer Asian Journal of Surgery Adjuvant chemotherapy Pancreatic cancer Prognostic nutritional index S-1 Skeletal muscle mass index |
| title | Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer |
| title_full | Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer |
| title_fullStr | Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer |
| title_full_unstemmed | Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer |
| title_short | Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer |
| title_sort | clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer |
| topic | Adjuvant chemotherapy Pancreatic cancer Prognostic nutritional index S-1 Skeletal muscle mass index |
| url | http://www.sciencedirect.com/science/article/pii/S1015958424024849 |
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