Neoadjuvant treatment: A window of opportunity for nutritional prehabilitation in patients with pancreatic ductal adenocarcinoma

Emanuele Rinninella, Emilio Bria, Sergio Alfieri, Antonio Gasbarrini, Giampaolo Tortora, Maria Cristina Mele, Futura Grassi, Carmelo Pozzo, Ilaria Trestini, Marco Cintoni, Salvatore Paiella, Roberto Salvia, Michele Milella

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Patients affected by pancreatic ductal adenocarcinoma (PDAC) frequently present with advanced disease at the time of diagnosis, limiting an upfront surgical approach. Neoadjuvant treatment (NAT) has become the standard of care to downstage non-metastatic locally advanced PDAC. However, this treatment increases the risk of a nutritional status decline, which in turn, may impact therapeutic tolerance, postoperative outcomes, or even prevent the possibility of surgery. Literature on prehabilitation programs on surgical PDAC patients show a reduction of postoperative complications, length of hospital stay, and readmission rate, while data on prehabilitation in NAT patients are scarce and randomized controlled trials are still missing. Particularly, appropriate nutritional management represents an important therapeutic strategy to promote tissue healing and to enhance patient recovery after surgical trauma. In this regard, NAT may represent a new interesting window of opportunity to implement a nutritional prehabilitation program, aiming to increase the PDAC patient's capacity to complete the planned therapy and potentially improve clinical and survival outcomes. Given these perspectives, this review attempts to provide an in-depth view of the nutritional derangements during NAT and nutritional prehabilitation program as well as their impact on PDAC patient outcomes.
Lingua originaleEnglish
pagine (da-a)885-903
Numero di pagine19
RivistaWORLD JOURNAL OF GASTROINTESTINAL SURGERY
Volume13
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Malnutrition
  • Neoadjuvant treatment
  • Nutritional prehabilitation
  • Nutritional status
  • Pancreatic cancer
  • Pancreatic cancer surgery

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