Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2015

01-07-2015 | Pancreatic Tumors

Postoperative Serum Albumin Level is a Marker of Incomplete Adjuvant Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma

Authors: Ippei Matsumoto, MD, PhD, Masaki Tanaka, MD, PhD, Sachiyo Shirakawa, MD, PhD, Makoto Shinzeki, MD, PhD, Hirochika Toyama, MD, PhD, Sadaki Asari, MD, PhD, Tadahiro Goto, MD, PhD, Hironori Yamashita, MD, PhD, Jun Ishida, MD, Tetsuo Ajiki, MD, PhD, Takumi Fukumoto, MD, PhD, Mototsugu Shimokawa, PhD, Yonson Ku, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2015

Login to get access

Abstract

Background

Adjuvant chemotherapy (AC) is recommended as a standard treatment after curative resection in patients with pancreatic adenocarcinoma (PA). Although patients who failed to complete AC had significantly worse survival compared with those who completed AC for cancers in various organs, the effects of complete AC on survival in patients with PA have not been investigated. The purpose of this study was to clarify the impact of complete AC on PA patient survival and to identify independent risk factors for incomplete AC.

Methods

Medical records of 236 consecutive PA patients who planned to undergo surgical resection with curative intent between January 2000 and September 2012 at Kobe University Hospital were retrospectively reviewed. Of these, the complete AC (n = 75) and the incomplete AC (n = 30) groups due to adverse events were compared.

Results

Patient survival was significantly better in the complete AC group than in the incomplete AC group (median survival time 48.9 vs. 17.9 months; 5-year survival rate 42.7 vs. 17.1 %; p < 0.0001). Preoperative white blood cell count and postoperative serum albumin level were identified as independent risk factors for incomplete AC. By receiver operating characteristic curve analysis, the cutoff value of postoperative serum albumin level was 3.1 mg/dL.

Conclusions

PA patients who completed AC had significantly better survival than those who failed to complete AC. Postoperative serum albumin level is a marker for failure to complete AC. Further prospective studies are needed to determine whether perioperative nutritional intervention could increase AC completion rate and improve prognosis in PA patients.
Literature
1.
Neoptolemos JP, Stocken DD, Bassi C, et al. Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial. JAMA. 2010;304(10):1073–81.PubMedCrossRef
2.
Oettle H, Neuhaus P, Hochhaus A, et al. Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA. 2013;310(14):1473–81.PubMedCrossRef
3.
Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350(12):1200–10.PubMedCrossRef
4.
Oettle H, Post S, Neuhaus P, et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA. 2007;297(3):267–77.PubMedCrossRef
5.
Ueno H, Kosuge T, Matsuyama Y, et al. A randomised phase III trial comparing gemcitabine with surgery-only in patients with resected pancreatic cancer: Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer. Br J Cancer. 2009;101(6):908–15.PubMedCentralPubMedCrossRef
6.
Morris M, Platell C, Fritschi L, Iacopetta B. Failure to complete adjuvant chemotherapy is associated with adverse survival in stage III colon cancer patients. Br J Cancer. 2007;96(5):701–7.PubMedCentralPubMedCrossRef
7.
Aoyama T, Yoshikawa T, Shirai J, et al. Body weight loss after surgery is an independent risk factor for continuation of S-1 adjuvant chemotherapy for gastric cancer. Ann Surg Oncol. 2013;20(6):2000–6.PubMedCrossRef
8.
Fairfield KM, Murray K, Lucas FL, et al. Completion of adjuvant chemotherapy and use of health services for older women with epithelial ovarian cancer. J Clin Oncol. 2011;29(29):3921–6.PubMedCrossRef
9.
Lohrisch C, Paltiel C, Gelmon K, Speers C, Taylor S, Barnett J, et al. Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol. 2006;24(30):4888–94.PubMedCrossRef
10.
Sobin LH, Gospodarowicz MK, Wittekind C (eds). International Union Against Cancer (UICC). TNM classification of malignant tumors. 7th ed. New York: Wiley-Blackwell; 2010.
11.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCentralPubMedCrossRef
12.
Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007;142(5):761–8.PubMedCrossRef
13.
Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13.PubMedCrossRef
14.
Nurgalieva ZZ, Franzini L, Morgan RO, Vernon SW, Liu CC, Du XL. Impact of timing of adjuvant chemotherapy initiation and completion after surgery on racial disparities in survival among women with breast cancer. Med Oncol. 2013;30(1):419.PubMedCrossRef
15.
Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17(6):432–7.PubMedCrossRef
16.
17.
Makary MA, Segev DL, Pronovost PJ, et al. Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg. 2010;210(6):901–8.PubMedCrossRef
18.
19.
Dobrila-Dintinjana R, Trivanovic D, Zelic M, et al. Nutritional support in patients with colorectal cancer during chemotherapy: does it work? Hepatogastroenterology. 2012;60(123):475–80.
20.
La Torre M, Nigri G, Cavallini M, Mercantini P, Ziparo V, Ramacciato G. The Glasgow Prognostic Score as a predictor of survival in patients with potentially resectable pancreatic adenocarcinoma. Ann Surg Oncol. 2012;19(9):2917–23.PubMedCrossRef
21.
Jamieson NB, Denley SM, Logue J, et al. A prospective comparison of the prognostic value of tumor- and patient-related factors in patients undergoing potentially curative surgery for pancreatic ductal adenocarcinoma. Ann Surg Oncol. 2011;18(8):2318–28.PubMedCrossRef
22.
Park JS, Chung HK, Hwang HK, Kim JK, Yoon DS. Postoperative nutritional effects of early enteral feeding compared with total parental nutrition in pancreaticoduodectomy patients: a prosepective, randomized study. J Korean Med Sci. 2012;27(3):261–7.PubMedCentralPubMedCrossRef
23.
Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS) Society recommendations. Clin Nutr. 2012;31(6):817–30.PubMedCrossRef
24.
Baradi H, Walsh RM, Henderson JM, Vogt D, Popovich M. Postoperative jejunal feeding and outcome of pancreaticoduodenectomy. J Gastrointest Surg. 2004;8(4):428–33.PubMedCrossRef
25.
Yang H, Feng Y, Sun X, Teitelbaum DH. Enteral versus parenteral nutrition: effect on intestinal barrier function. Ann N Y Acad Sci. 2009;1165:338–46.PubMedCentralPubMedCrossRef
Metadata
Title
Postoperative Serum Albumin Level is a Marker of Incomplete Adjuvant Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma
Authors
Ippei Matsumoto, MD, PhD
Masaki Tanaka, MD, PhD
Sachiyo Shirakawa, MD, PhD
Makoto Shinzeki, MD, PhD
Hirochika Toyama, MD, PhD
Sadaki Asari, MD, PhD
Tadahiro Goto, MD, PhD
Hironori Yamashita, MD, PhD
Jun Ishida, MD
Tetsuo Ajiki, MD, PhD
Takumi Fukumoto, MD, PhD
Mototsugu Shimokawa, PhD
Yonson Ku, MD, PhD
Publication date
01-07-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 7/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4280-7

Other articles of this Issue 7/2015

Annals of Surgical Oncology 7/2015 Go to the issue

Breast Oncology

Second Axillary Sentinel Lymph Node Biopsy for Breast Tumor Recurrence: Experience of the European Institute of Oncology

Colorectal Cancer

Metastatic Colorectal Cancer to the Liver: Involve the Surgeon Early and Often

Colorectal Cancer

Is Liver Transplantation an Option in Colorectal Cancer Patients with Nonresectable Liver Metastases and Progression on All Lines of Standard Chemotherapy?

Urologic Oncology

Elevated Expression of N-Acetylgalactosaminyltransferase 10 Predicts Poor Survival and Early Recurrence of Patients with Clear-Cell Renal Cell Carcinoma

Endocrine Tumors

Improving Outcomes in Adrenocortical Cancer: An Australian Perspective

Hepatobiliary Tumors

Analysis of Recurrence Patterns After Anatomical or Non-anatomical Resection for Hepatocellular Carcinoma