Impact of preoperative malnutrition, based on albumin level and body mass index, on operative outcomes in patients with pancreatic head cancer

다국어 초록 (Multilingual Abstract)

To investigate whether preoperative malnutrition in patients who underwent curative pancreaticoduodenectomy (PD) in pancreatic head cancer correlated with short‐term outcomes.
This study was a retrospective review of medical records from January 2004 to December 2018. Preoperative malnutrition was defined as body mass index (BMI) <18.5 kg/m2, or hypoalbuminemia with serum albumin level < 3.5 g/dL within 30 days before surgery.
Of the 289 eligible patients, 60 patients (20.7%) were classified as the malnutrition group. The estimated blood loss (EBL, mL) (964.1 ± 879.7 vs 597.7 ± 501.7, P = .044) and transfusion rate (51.7% vs 18.8%, P < .001) was significantly higher in the malnutrition group than no‐malnutrition group. The hospital stay (days) (20.5 ± 12.2 vs 18.1 ± 13.6, P = .05) was significantly longer in the malnutrition group. The open conversion rate (45.4% vs 6.67%, P < .001) and major complication rate (36.7% vs 21.8%, P = .032) was significantly higher in the malnutrition group. In multivariate analysis, preoperative malnutrition was found to be the predictor of postoperative complication (HR 1.971 95% confidence interval 1.071‐3.624, P = .029).
Preoperative malnutrition in patients who underwent curative PD for pancreatic head cancer is associated with adverse short‐term outcomes.
Highlight
No study has been reported on the association between preoperative malnutrition and surgical outcomes in pancreatic cancer. Among patients who underwent curative pancreaticoduodenectomy, Lee and colleagues revealed that those with preoperative malnutrition had increased blood loss, open conversion rates, hospital stay, and complication rates compared with those without preoperative malnutrition.