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Postoperative nonalcoholic fatty liver disease is correlated with malnutrition leading to an unpreferable clinical course for pancreatic cancer patients undergoing pancreaticoduodenectomy

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Abstract

Purposes

This study aimed to clarify the impact of postoperative nonalcoholic fatty liver disease (NAFLD) on the clinical course of patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

One hundred and eight patients with pancreatic cancer undergoing pancreaticoduodenectomy (PD) with curative intent in between 2005 and 2016 were enrolled in this study. Post-PD NAFLD was assessed by computed tomography (CT), which was routinely performed at 3 months, 6 months, and 1 year after surgery. The clinical impact of post-PD NAFLD was examined from an oncological perspective.

Results

There were 50 (46.2%) post-PD NAFLD patients. The NAFLD group showed significantly lower CT values at 3 months, 6 months, and 1 year after surgery than those without NAFLD. Patients with NAFLD showed significant body weight loss and a decrease in serum albumin level after surgery compared with those without NAFLD. Consequently, the 70% completion rate of adjuvant chemotherapy with gemcitabine, but not S1, was significantly lower in the NAFLD group than in the non-NAFLD group. The 5-year overall survival and disease-free survival rates were comparable between the two groups.

Conclusion

Post-PD NAFLD was associated with malnutrition in patients with PDAC, reducing their tolerance to gemcitabine-based adjuvant chemotherapy. Post-PD NAFLD needs to be emphasized and requires special nutritional intervention in patients with PDAC.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, Kumamoto, 860-8556, Japan

    Hirohisa Okabe, Yo-ichi Yamashita, Risa Inoue, Shotaro Kinoshita, Rumi Itoyama, Toshihiko Yusa, Yosuke Nakao, Takanobu Yamao, Naoki Umezaki, Masayo Tsukamoto, Yuki Kitano, Tatsunori Miyata, Kota Arima, Hiromitsu Hayashi, Katsunori Imai, Akira Chikamoto & Hideo Baba

Authors
  1. Hirohisa Okabe
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  2. Yo-ichi Yamashita
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  3. Risa Inoue
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  4. Shotaro Kinoshita
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  5. Rumi Itoyama
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  6. Toshihiko Yusa
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  7. Yosuke Nakao
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  8. Takanobu Yamao
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  13. Kota Arima
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  14. Hiromitsu Hayashi
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  15. Katsunori Imai
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  16. Akira Chikamoto
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  17. Hideo Baba
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Contributions

Conceived, performed, analyzed, and designed the experiments: HO. Wrote the paper: HO. Edited the article: YY and HB. Data collection: RI, SK, RI, TY, YN, TY, NU, MT, YK, TM, and KA. Discussed and advised on the content of the article: YY, HY, KI, and AC.

Corresponding author

Correspondence to Hirohisa Okabe.

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None of the authors have any conflicts of interest to disclose.

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Okabe, H., Yamashita, Yi., Inoue, R. et al. Postoperative nonalcoholic fatty liver disease is correlated with malnutrition leading to an unpreferable clinical course for pancreatic cancer patients undergoing pancreaticoduodenectomy. Surg Today 50, 193–199 (2020). https://doi.org/10.1007/s00595-019-01866-x

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  • DOI: https://doi.org/10.1007/s00595-019-01866-x

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