Séance

50 - Communication libre
Pancreas
3 juin 2021, 13:50 - 15:20, Stream 2: SSCViscérale

Abstract

4
Prospective trial to evaluate the prognostic value of different nutritional assessment scores for survival in pancreatic cancer surgery
P. Probst, M. Heckler, T. Hackert, P. Knebel, M. W. Büchler, M. K. Diener, Presenter: P. Probst (Heidelberg)

Objective
Malnutrition is associated with poor survival in pancreatic cancer patients. Nutritional scores show great heterogeneity diagnosing malnutrition. The aim of this study was to find the score best suitable to identify patients with malnutrition related to worse survival after surgery for PDAC.
Methods
Risk of malnutrition was evaluated preoperatively using twelve nutritional assessment scores. Patients were followed-up prospectively for at least 3 years. Patients at risk for malnutrition were compared to those not at risk according to each score using Kaplan Meier survival statistics.
Results
A total of 116 Patients receiving a PDAC resection in curative intent were included. Malnutrition according to the Subjective Global Assessment score (SGA), the Short Nutritional Assessment Questionnaire (SNAQ) and the INSYST2 score was associated with worse overall survival (SGA: at-risk: 392 days; not at-risk: 942 days; p=0.001; SNAQ: at-risk: 508 days; not at-risk: 971 days; p=0.027; INSYST2: at-risk: 538 days; not at risk: 1068; p=0.049). In the multivariate analysis SGA (HR of death 2.22, 95% CI 1.37-3.6, p=0.002) was associated with worse overall survival.
Conclusion
Malnutrition as defined by the Subjective Global Assessment is independently associated with worse survival in resected PDAC patients. The SGA should be used to stratify PDAC patients in clinical studies. If severely malnourished patients according to the SGA profit from intensified nutritional therapy should be evaluated in a randomized controlled trial.
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