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Tytuł:
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Long-term changes in nutritional status and body composition in patients with malignant pancreatic disease - A systematic review.
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Autorzy:
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Phillips ME; Royal Surrey Hospital NHS Foundation Trust, Egerton Road, Guildford, UK; Department of Nutritional Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK. Electronic address: .
Robertson MD; Department of Nutritional Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK.
Hart K; Department of Nutritional Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK.
Kumar R; Royal Surrey Hospital NHS Foundation Trust, Egerton Road, Guildford, UK.
Pencavel T; Royal Surrey Hospital NHS Foundation Trust, Egerton Road, Guildford, UK.
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Źródło:
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Clinical nutrition ESPEN [Clin Nutr ESPEN] 2021 Aug; Vol. 44, pp. 85-95. Date of Electronic Publication: 2021 Jun 10.
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Typ publikacji:
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Journal Article; Systematic Review
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Język:
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English
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Imprint Name(s):
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Original Publication: [Oxford] : Elsevier Ltd., [2015]-
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MeSH Terms:
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Malnutrition*/diagnosis
Malnutrition*/epidemiology
Pancreatic Diseases*
Body Composition ; Humans ; Nutritional Status ; Retrospective Studies
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Contributed Indexing:
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Keywords: Malnutrition; Pancreatic cancer; Sarcopenia
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Entry Date(s):
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Date Created: 20210731 Date Completed: 20210924 Latest Revision: 20210924
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Update Code:
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20240105
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DOI:
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10.1016/j.clnesp.2021.05.026
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PMID:
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34330517
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Background and Aims: Patients with pancreatic cancer often experience significant deterioration in nutritional status over time. Malnutrition is complex and multifactorial, with malabsorption, pain, toxic dependencies, co-morbidities and malignant processes all playing a role. The aims of this systematic review were to assess nutritional changes over time and identify tolerance of nutritional intervention, thus identifying potential areas for further research to improve patient outcomes.
Materials and Methods: A systematic review of MEDLINE, EMBASE and PubMed was carried out in February 2020, identifying 2620 articles. After screening to exclude those reporting short-term measures, with only one data point, or in the wrong population, thirteen papers were selected for analysis (four trials in neo-adjuvant treatment, five in populations undergoing palliative treatment for pancreatic cancer, and four in mixed populations undergoing pancreatic resection).
Results: Overall, studies were limited by predominantly retrospective designs, and poor control of potentially confounding variables. Meta-analysis could not be performed due to heterogenicity in study design and reporting methods. Surgery in mixed cohorts did not appear to result in weight loss. Only one small intervention study was identified. Patients with pancreatic cancer experienced a decline in nutritional status, with 44-63% of patients undergoing neoadjuvant chemotherapy having low muscle mass prior to starting treatment.
Conclusion: There is a paucity of data regarding nutritional intervention in pancreatic cancer. Future work should include the use of validated functional and clinical assessment tools to further explore the impact of nutritional intervention, and the relationship between nutritional status and outcome.
Competing Interests: Declaration of competing interest MEP has received honoria for speaking from Mylan Pharmaceuticals, Nutricia Clinical Care, Merck and Sanofi. RK has received honoria for speaking from Mylan Pharmaceuticals. MR, KH and TP have no conflicts of interest to declare.
(Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
