Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic Cancer

<b>Background/Objectives</b>: This study aimed to investigate the impact of preoperative weight loss on long-term postoperative survival and the significance of preoperative nutrition on perioperative weight change in patients with pancreatic cancer. <b>Methods</b>: Overall,...

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Main Authors: Mariko Tsukagoshi, Kenichiro Araki, Norio Kubo, Takamichi Igarashi, Shunsuke Kawai, Kei Hagiwara, Kouki Hoshino, Takaomi Seki, Takayuki Okuyama, Ryosuke Fukushima, Takahiro Shoda, Ken Shirabe
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Language:English
Published: MDPI AG 2025-07-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/7/1703
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author Mariko Tsukagoshi
Kenichiro Araki
Norio Kubo
Takamichi Igarashi
Shunsuke Kawai
Kei Hagiwara
Kouki Hoshino
Takaomi Seki
Takayuki Okuyama
Ryosuke Fukushima
Takahiro Shoda
Ken Shirabe
author_facet Mariko Tsukagoshi
Kenichiro Araki
Norio Kubo
Takamichi Igarashi
Shunsuke Kawai
Kei Hagiwara
Kouki Hoshino
Takaomi Seki
Takayuki Okuyama
Ryosuke Fukushima
Takahiro Shoda
Ken Shirabe
author_sort Mariko Tsukagoshi
collection DOAJ
description <b>Background/Objectives</b>: This study aimed to investigate the impact of preoperative weight loss on long-term postoperative survival and the significance of preoperative nutrition on perioperative weight change in patients with pancreatic cancer. <b>Methods</b>: Overall, 125 patients who underwent radical resection for invasive pancreatic ductal carcinoma were retrospectively analyzed. The preoperative weight loss rate (pre-%WL) from the initial visit to immediately before surgery was calculated. Patients were classified by pre-%WL into the weight-loss (≥6% loss) and weight-maintenance (<6% loss) groups. The association of pre-%WL with postoperative outcomes and long-term survival was assessed. We evaluated preoperative nutrition’s effect on perioperative weight change. <b>Results</b>: The study cohort included 91 (73%) and 34 (27%) patients with weight maintenance and weight loss, respectively. Specifically, the weight-loss group had a longer operative time (<i>p</i> = 0.025) and greater blood loss (<i>p</i> = 0.018) than the weight-maintenance group. Patients with weight loss had significantly poorer recurrence-free survival (RFS; 8.7 vs. 17.8 months, <i>p</i> = 0.004) and overall survival (OS; 18.1 vs. 45.2 months, <i>p</i> = 0.002) than those with weight maintenance. Multivariate analysis revealed weight loss as an independent prognostic indicator of poor RFS (hazard ratio = 2.07; <i>p</i> = 0.003) and OS (hazard ratio = 2.55; <i>p</i> = 0.0008). The presence or absence of preoperative nutritional therapy was not correlated with the pre-%WL but was associated with postoperative (by the time of discharge) weight loss rate (median weight change rate: −2.9% vs. −5.6%, <i>p</i> = 0.001). <b>Conclusions</b>: Preoperative weight loss ≥ 6% was associated with poor RFS and OS in patients with pancreatic cancer. Although preoperative nutritional therapy did not suppress preoperative weight loss, it suppressed postoperative weight loss.
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spelling doaj-art-d840650140b240c1a859f7c2eabb49c82025-08-20T03:35:58ZengMDPI AGBiomedicines2227-90592025-07-01137170310.3390/biomedicines13071703Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic CancerMariko Tsukagoshi0Kenichiro Araki1Norio Kubo2Takamichi Igarashi3Shunsuke Kawai4Kei Hagiwara5Kouki Hoshino6Takaomi Seki7Takayuki Okuyama8Ryosuke Fukushima9Takahiro Shoda10Ken Shirabe11Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, JapanDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan<b>Background/Objectives</b>: This study aimed to investigate the impact of preoperative weight loss on long-term postoperative survival and the significance of preoperative nutrition on perioperative weight change in patients with pancreatic cancer. <b>Methods</b>: Overall, 125 patients who underwent radical resection for invasive pancreatic ductal carcinoma were retrospectively analyzed. The preoperative weight loss rate (pre-%WL) from the initial visit to immediately before surgery was calculated. Patients were classified by pre-%WL into the weight-loss (≥6% loss) and weight-maintenance (<6% loss) groups. The association of pre-%WL with postoperative outcomes and long-term survival was assessed. We evaluated preoperative nutrition’s effect on perioperative weight change. <b>Results</b>: The study cohort included 91 (73%) and 34 (27%) patients with weight maintenance and weight loss, respectively. Specifically, the weight-loss group had a longer operative time (<i>p</i> = 0.025) and greater blood loss (<i>p</i> = 0.018) than the weight-maintenance group. Patients with weight loss had significantly poorer recurrence-free survival (RFS; 8.7 vs. 17.8 months, <i>p</i> = 0.004) and overall survival (OS; 18.1 vs. 45.2 months, <i>p</i> = 0.002) than those with weight maintenance. Multivariate analysis revealed weight loss as an independent prognostic indicator of poor RFS (hazard ratio = 2.07; <i>p</i> = 0.003) and OS (hazard ratio = 2.55; <i>p</i> = 0.0008). The presence or absence of preoperative nutritional therapy was not correlated with the pre-%WL but was associated with postoperative (by the time of discharge) weight loss rate (median weight change rate: −2.9% vs. −5.6%, <i>p</i> = 0.001). <b>Conclusions</b>: Preoperative weight loss ≥ 6% was associated with poor RFS and OS in patients with pancreatic cancer. Although preoperative nutritional therapy did not suppress preoperative weight loss, it suppressed postoperative weight loss.https://www.mdpi.com/2227-9059/13/7/1703body weightnutritionoutcomepancreatic cancerprognosissurgery
spellingShingle Mariko Tsukagoshi
Kenichiro Araki
Norio Kubo
Takamichi Igarashi
Shunsuke Kawai
Kei Hagiwara
Kouki Hoshino
Takaomi Seki
Takayuki Okuyama
Ryosuke Fukushima
Takahiro Shoda
Ken Shirabe
Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic Cancer
Biomedicines
body weight
nutrition
outcome
pancreatic cancer
prognosis
surgery
title Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic Cancer
title_full Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic Cancer
title_fullStr Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic Cancer
title_full_unstemmed Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic Cancer
title_short Impact of Preoperative Weight Loss on Prognosis in Patients with Pancreatic Cancer
title_sort impact of preoperative weight loss on prognosis in patients with pancreatic cancer
topic body weight
nutrition
outcome
pancreatic cancer
prognosis
surgery
url https://www.mdpi.com/2227-9059/13/7/1703
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