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Impact of the controlling nutritional status score on severe postoperative complications of pancreaticoduodenectomy for pancreatic cancer

  • Original Article
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Abstract

Purpose

The controlling nutritional status (CONUT) score is a useful biomarker to evaluate undernutrition. However, there have been few reports describing the correlation between postoperative complications and the CONUT score for pancreatic cancer. Therefore, this study aimed to assess the impact of the CONUT score on the postoperative complications of pancreaticoduodenectomy (PD) in patients with pancreatic cancer.

Methods

We retrospectively analyzed 206 consecutive patients with pancreatic cancer who underwent PD over a 12-year duration at our institution. The patients were divided into two groups based on preoperative CONUT scores; their clinicopathological characteristics and surgical outcomes were compared. Furthermore, we compared the CONUT score with preoperative clinical factors and several nutritional biomarkers for postoperative complications using univariate and multivariate analyses.

Results

Postoperative complications of Clavien–Dindo grade ≥ IIIa and those of Clavien–Dindo grade ≥ IIIb occurred in 29 (14.1%) and 9 (4.4%) patients, respectively. The high CONUT score (≥5) group indicated that patients with an undernutrition status had a higher postoperative complication rate, poorer relapse-free survival, and overall survival rates than the low CONUT score (≤4) group. Among preoperative clinical factors, a high CONUT score was an independent risk factor for severe postoperative complications.

Conclusions

The CONUT score may be a useful parameter in the identification of patients undergoing pancreatic surgery who are susceptible to postoperative complications.

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Acknowledgements

The authors thank Editage (www.editage.jp) for English language editing.

Funding

This work was funded by the JSPS KAKENHI (grant number 18K08632). The funder had no role in the study design; collection, analysis, and interpretation of data; writing of the report; and decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, 8-1 Kawada-cho Shinjuku-ku, Tokyo, 162-8666, Japan

    Masahiro Shiihara, Ryota Higuchi, Wataru Izumo, Takehisa Yazawa, Shuichiro Uemura & Masakazu Yamamoto

  2. Department of Investigative Pathology, Tohoku University Graduate School of Medicine, Miyagi, Japan

    Masahiro Shiihara & Toru Furukawa

Authors
  1. Masahiro Shiihara
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  2. Ryota Higuchi
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  3. Wataru Izumo
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  4. Takehisa Yazawa
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  5. Shuichiro Uemura
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  6. Toru Furukawa
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  7. Masakazu Yamamoto
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Contributions

Study conception and design: M.S and R.H.

Acquisition of data: M.S, R.H, T.Y, S.U, W.I, and M.Y.

Analysis and interpretation of data: M.S and R.H

Pathological diagnosis: T.F.

Draft and critical analysis: M.S, R.H, and M.Y.

Corresponding author

Correspondence to Ryota Higuchi.

Ethics declarations

Ethics approval and consent to participate

All procedures involving human participants in this study were in accordance with the ethical standards of this institutional research committee and with the 1964 Helsinki Declaration. The requirement to obtain written informed consent from each patient was waived due to the study’s retrospective design. We used an “opt-out” method that was in accordance with the ethical guidelines.

Consent for publication

Not applicable.

Conflict of interest

The authors declare no competing interests.

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Shiihara, M., Higuchi, R., Izumo, W. et al. Impact of the controlling nutritional status score on severe postoperative complications of pancreaticoduodenectomy for pancreatic cancer. Langenbecks Arch Surg 406, 1491–1498 (2021). https://doi.org/10.1007/s00423-021-02151-7

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  • DOI: https://doi.org/10.1007/s00423-021-02151-7

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