Abstract
Introduction: Pancreatic cancer is associated with poor outcomes, and surgery is the only curative treatment for pancreatic head cancer, though prognostic factors are limited. This study aims to evaluate the effectiveness of the Prognostic Nutritional Index (PNI) in predicting outcomes in a Vietnamese population undergoing the Whipple procedure.
Patients and Methods: A total of 89 patients who underwent the Whipple procedure for pancreatic head cancer between January 2013 and August 2020 at Viet Duc University Hospital were included. The patients were classified into two groups based on their PNI: <50 and ≥ 50.
Results: Statistically significant differences were observed between the two groups in terms of lymphocyte count (1.6 ± 0.6 vs. 2.2 ± 0.7) and albumin levels (36.8 ± 3.9 vs. 42.4 ± 2.8) (P<0.05). Complications above grade III were more common in the PNI <50 group (12.5%) compared to the PNI ≥ 50 group (3%). Although the 3-year survival rate was higher in the PNI ≥50 group, the difference was not statistically significant.
Conclusion: Larger studies are needed to confirm the prognostic role of this index in Whipple procedure surgery.
Keywords: Prognostic nutrition index, pancreatic head cancer, pancreaticoduodenectomy.
References
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. Sep 12 2018;doi:10.3322/caac.21492
- Dang C, Wang M, Zhu F, Qin T, Qin R. Controlling nutritional status (CONUT) score-based nomogram to predict overall survival of patients with pancreatic cancer undergoing radical surgery. Asian J Surg. Jun 2022;45(6):1237-1245. doi:10.1016/j.asjsur.2021.08.011
- Zhao P, Wu Z, Wang Z, Wu C, Huang X, Tian B. Prognostic role of the prognostic nutritional index in patients with pancreatic cancer who underwent curative resection without preoperative neoadjuvant treatment: Asystematic review and meta-analysis. Front Surg. 2022;9:992641. doi:10.3389/fsurg.2022.992641
- Onodera T, Goseki N, Kosaki G. [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi. Sep 1984;85(9):1001-5.
- Hue PK, Huong LT, Dinh LTK. Nutritional status of patients undergoing peritoneal surgery at the Department of general surgery in Can Tho central general Hospital. Vietnam Medical Journal. 2023;529(1B)
- Evaluation of patient care results after pancreaticoduodenectomy. Journal of 108 – Clinical medicine and pharmacy. 2020;15
- Baba H, Sanada T, Goseki N. Preoperative malnutrition is associated with prognosis of pancreatic cancer. HPB. 2011;
- Melis M, Marcon F, Masi A, et al. The safety of a pancreaticoduodenectomy in patients older than 80 years: risk vs. benefits. HPB. 2012;14(9):583-588. doi:https://doi.org/10.1111/j.1477-2574.2012.00484.x
- Karayiannakis AJ, Syrigos KN, Polychronidis A, Pitiakoudis M, Bounovas A, Simopoulos K. Serum levels of tumor necrosis factor-alpha and nutritional status in pancreatic cancer patients. Anticancer Res. Mar-Apr 2001;21(2b):1355-8.
- Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. Mar 19 2010;140(6):883-99. doi:10.1016/j.cell.2010.01.025
- Li Q, Feng Z, Miao R, Liu X, Liu C, Liu Z. Prognosis and survival analysis of patients with pancreatic cancer: retrospective experience of a single institution. World journal of surgical oncology. Jan 7 2022;20(1):11. doi:10.1186/s12957-021-02478-x
- Sanchez Leon RM, Rajaraman A, Kubwimana MN. Optimizing Nutritional Status of Patients Prior to Major Surgical Intervention. Methodist Debakey Cardiovasc J. 2023;19(4):85-96. doi:10.14797/mdcvj.1248