ASO Author Reflections: Recurrence Following Post-neoadjuvant Pancreatectomy: How Can We Do Better?

N/

Body composition parameters, immunonutritional indexes, and surgical outcome of pancreatic cancer patients resected after neoadjuvant therapy: A retrospective, multicenter analysis

Background and aims: Body composition parameters and immunonutritional indexes provide useful information on the nutritional and inflammatory status of patients. We sought to investigate whether they predict the postoperative outcome in patients with pancreatic cancer (PC) who received neoadjuvant therapy (NAT) and then pancreaticoduodenectomy. Methods: Data from locally advanced PC patients who underwent NAT followed by pancreaticoduodenectomy between January 2012 and December 2019 in four high-volume institutions were collected retrospectively. Only patients with two available CT scans (before and after NAT) and immunonutritional indexes (before surgery) available were included. Body composition was assessed and immunonutritional indexes collected were: VAT, SAT, SMI, SMA, PLR, NLR, LMR, and PNI. The postoperative outcomes evaluated were overall morbidity (any complication occurring), major complications (Clavien-Dindo ≥ 3), and length of stay. Results: One hundred twenty-one patients met the inclusion criteria and constituted the study population. The median age at the diagnosis was 64 years (IQR16), and the median BMI was 24 kg/m2 (IQR 4.1). The median time between the two CT-scan examined was 188 days (IQR 48). Skeletal muscle index (SMI) decreased after NAT, with a median delta of −7.8 cm2/m2 (p < 0.05). Major complications occurred more frequently in patients with a lower pre-NAT SMI (p = 0.035) and in those who gained in subcutaneous adipose tissue (SAT) compartment during NAT (p = 0.043). Patients with a gain in SMI experienced fewer major postoperative complications (p = 0.002). The presence of Low muscle mass after NAT was associated with a longer hospital stay [Beta 5.1, 95%CI (1.5, 8.7), p = 0.006]. An increase in SMI from 35 to 40 cm2/m2 was a protective factor with respect to overall postoperative complications [OR 0.43, 95% (CI 0.21, 0.86), p < 0.001]. None of the immunonutritional indexes investigated predicted the postoperative outcome. Conclusion: Body composition changes during NAT are associated with surgical outcome in PC patients who receive pancreaticoduodenectomy after NAT. An increase in SMI during NAT should be favored to ameliorate the postoperative outcome. Immunonutritional indexes did not show to be capable of predicting the surgical outcome

ASO Visual Abstract: FOLFIRINOX or Gemcitabine Based Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: A Multi-Institutional, Patient-Level Meta-Analysis and Systematic Review

N/

Intraductal Papillary Mucinous Neoplasm Around the World

No abstract availabl

Quality of Life in Italian Official Surveys

Quality-of-life studies have a 50-year history and inherited the tradition of the ‘‘social indicators’’ movement, born in the United States during the sixties and involving scholars and researchers, supported by the public administration and interested in gathering and analysing data aimed at studying non-economic components of societal wellbeing. The idea of quantifying ‘‘symptoms’’ (indicators) of living conditions has been launched by Italian statistician and criminologist, Alfredo Niceforo, who has been recognised as the pioneer of social-indicators concept. Moreover, with his book on Les indices numèrique dela civilisation et du progrés, he may be considered the originator of an approach of comprehensive welfare and quality of life measurement as it is the concern of modern social indicators and quality of life

Pasireotide for the Prevention of Postoperative Pancreatic Fistula: Time to Curb the Enthusiasm?

This is a Letter to the Editor on the use of Pasireotide for the prevention of pancreatic fistul

ASO Author Reflection: Location of Nodal Metastases in Pancreatoduodenectomy for Cancer: Which Station Matters?

No abstract availabl

Response to: Managing the High-risk Pancreatic Anastomosis

This a response to Pedrazzoli et al on our paper "Characterization and Optimal Management of High-risk Pancreatic Anastomoses During Pancreatoduodenectomy

Pancreatic Adenocarcinoma

this chapter outline the Mechaniss of Tumour Dissemination in Pancreatic cance