TY - JOUR
T1 - Nutritional support in pancreatic cancer patients and its effect on nutritional status
T2 - an observational regional HPB network study investigating current practice
AU - Wijma, Allard G
AU - Hogenbirk, Rianne N M
AU - Driessens, Heleen
AU - Kluifhooft, Daniëlle A
AU - Jellema-Betten, Ellen S
AU - Tjalsma-de Vries, Marlies
AU - Liem, Mike S L
AU - Nieuwenhuijs, Vincent B
AU - Manusama, Eric M
AU - Hoogwater, Frederik J H
AU - Nijkamp, Maarten W
AU - Beijer, Sandra
AU - Klaase, Joost M
N1 - © 2024. The Author(s).
PY - 2024/7/5
Y1 - 2024/7/5
N2 - PURPOSE: Preoperative malnutrition is associated with poor postoperative outcomes in patients with pancreatic cancer. This study evaluated the effectiveness of current practice in nutritional support for patients with pancreatic cancer.METHODS: Observational multicenter HPB network study conducted at the Isala Clinics Zwolle, Medical Spectrum Twente, Medical Center Leeuwarden, and University Medical Center Groningen between October 2021 and May 2023. Patients with a suspected pancreatic malignancy scheduled for surgery were screened for malnutrition using the Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire and referred to a dedicated dietician for nutritional support comprising pancreatic enzyme replacement therapy, dietary advice, and nutritional supplements to achieve adequate caloric and protein intake. At baseline, 1 day preoperatively, and 3 months postoperatively, the nutritional status and muscle thickness were evaluated.RESULTS: The study included 30 patients, of whom 12 (40%) classified as malnourished (PG-SGA ≥ 4) at baseline. Compared to well-nourished patients, malnourished patients were younger, were predominantly female, and had a higher body mass index, despite having lost more body weight in the past 6 months. All malnourished patients and 78% of the well-nourished patients received nutritional support. Consequently, a preoperative increase in caloric and protein intake and body weight were observed. Postoperatively, despite a further increase in caloric intake, a considerable decrease in protein intake, body weight, and muscle thickness was observed.CONCLUSION: Malnutrition is prevalent in patients undergoing pancreatic surgery. Nutritional support by a dedicated dietician is effective in enhancing patients' preoperative nutritional status. However, postoperative monitoring of adequate nutritional intake in patients could be improved.
AB - PURPOSE: Preoperative malnutrition is associated with poor postoperative outcomes in patients with pancreatic cancer. This study evaluated the effectiveness of current practice in nutritional support for patients with pancreatic cancer.METHODS: Observational multicenter HPB network study conducted at the Isala Clinics Zwolle, Medical Spectrum Twente, Medical Center Leeuwarden, and University Medical Center Groningen between October 2021 and May 2023. Patients with a suspected pancreatic malignancy scheduled for surgery were screened for malnutrition using the Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire and referred to a dedicated dietician for nutritional support comprising pancreatic enzyme replacement therapy, dietary advice, and nutritional supplements to achieve adequate caloric and protein intake. At baseline, 1 day preoperatively, and 3 months postoperatively, the nutritional status and muscle thickness were evaluated.RESULTS: The study included 30 patients, of whom 12 (40%) classified as malnourished (PG-SGA ≥ 4) at baseline. Compared to well-nourished patients, malnourished patients were younger, were predominantly female, and had a higher body mass index, despite having lost more body weight in the past 6 months. All malnourished patients and 78% of the well-nourished patients received nutritional support. Consequently, a preoperative increase in caloric and protein intake and body weight were observed. Postoperatively, despite a further increase in caloric intake, a considerable decrease in protein intake, body weight, and muscle thickness was observed.CONCLUSION: Malnutrition is prevalent in patients undergoing pancreatic surgery. Nutritional support by a dedicated dietician is effective in enhancing patients' preoperative nutritional status. However, postoperative monitoring of adequate nutritional intake in patients could be improved.
KW - Humans
KW - Pancreatic Neoplasms/complications
KW - Female
KW - Male
KW - Nutritional Status
KW - Nutritional Support/methods
KW - Aged
KW - Middle Aged
KW - Malnutrition/etiology
KW - Surveys and Questionnaires
KW - Aged, 80 and over
U2 - 10.1007/s00520-024-08683-0
DO - 10.1007/s00520-024-08683-0
M3 - Article
C2 - 38967804
SN - 0941-4355
VL - 32
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 7
M1 - 487
ER -