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Surgery Today
Published in: Surgery Today 11/2017

01-11-2017 | Original Article

The basal nutritional state of PDAC patients is the dominant factor for completing adjuvant chemotherapy

Authors: Daisaku Yamada, Hidetoshi Eguchi, Tadafumi Asaoka, Hideo Tomihara, Takehiro Noda, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Yutaka Takeda, Masahiro Tanemura, Masaki Mori, Yuichiro Doki

Published in: Surgery Today | Issue 11/2017

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Abstract

Purpose

Pancreatic ductal adenocarcinoma (PDAC) is highly lethal, and several clinical trials have shown that adjuvant chemotherapy after curative resection can improve the prognosis of these patients. However, the adjuvant chemotherapy completion rate is less than satisfactory. If this rate could be increased then the overall prognosis of PDAC might be improved; however, reports addressing this problem are insufficient. To elucidate the factors, we retrospectively investigated PDAC patients.

Methods

Various factors of 121 PDAC patients undergoing R0 resection, including preoperatively treated patients, were investigated. Univariate and multivariate analyses were performed to investigate the factors that were associated with the completion of adjuvant chemotherapy.

Results

The analysis identified age and the prognostic nutritional index (PNI) as significant independent factors. A receiver operating characteristic curve analysis of age yielded a cutoff value of 67 years (sensitivity, 64%; specificity, 78%). Univariate and multivariate analyses of the 61 patients who were over 67 years of age revealed that the PNI (odds ratio, 0.85; P = 0.048) and Evans grade (odds ratio, 0.041; P = 0.0010) were significant factors for the completion of chemotherapy.

Conclusions

The results of our investigation suggest that nutrition should be controlled in older PDAC patients to facilitate the completion of adjuvant chemotherapy.
Appendix
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Metadata
Title
The basal nutritional state of PDAC patients is the dominant factor for completing adjuvant chemotherapy
Authors
Daisaku Yamada
Hidetoshi Eguchi
Tadafumi Asaoka
Hideo Tomihara
Takehiro Noda
Hiroshi Wada
Koichi Kawamoto
Kunihito Gotoh
Yutaka Takeda
Masahiro Tanemura
Masaki Mori
Yuichiro Doki
Publication date
01-11-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 11/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-017-1522-x

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