Preoperative Risk Factors in Patients With Pancreatic Cancer

Naomi Kusama; Yuta Mitobe; Natsuko Hyodo; Tetsuya Miyashita; Yasuko Baba; Takuya Hashimoto; Yoshimi Inagaki

doi:10.14740/jocmr4906

Preoperative Risk Factors in Patients With Pancreatic Cancer

J Clin Med Res. 2023 Jun;15(6):300-309. doi: 10.14740/jocmr4906. Epub 2023 Jun 29.

Authors

Naomi Kusama¹, Yuta Mitobe², Natsuko Hyodo¹, Tetsuya Miyashita³, Yasuko Baba³, Takuya Hashimoto⁴, Yoshimi Inagaki⁵

Affiliations

¹ Master's Program, International University of Health and Welfare, Tokyo, Japan.
² Graduate School of Health and Welfare Science, International University of Health and Welfare, Tokyo, Japan.
³ Department of Anesthesiology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
⁴ Department of Hepatobiliary Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
⁵ Department of Anesthesiology, International University of Health and Welfare, Narita Hospital, Chiba, Japan.

Abstract

Background: Pancreatic cancer is gastrointestinal cancer with a poor prognosis. Although surgical techniques and chemotherapy have improved treatment outcomes, the 5-year survival rate for pancreatic cancer is less than 10%. In addition, resection of pancreatic cancer is highly invasive and is associated with high rates of postoperative complications and hospital mortality. The Japanese Pancreatic Association states that preoperative body composition assessment may predict postoperative complications. However, although impaired physical function is also a risk factor, few studies have examined it in combination with body composition. We examined preoperative nutritional status and physical function as risk factors for postoperative complications in pancreatic cancer patients.

Methods: Fifty-nine patients with pancreatic cancer who underwent surgical treatment and were discharged alive from January 1, 2018, to March 31, 2021, at the Japanese Red Cross Medical Center. This retrospective study was conducted using electronic medical records and a database of departments. Body composition and physical function were evaluated before and after surgery, and the risk factors between patients with and without complications were compared.

Results: Fifty-nine patients were analyzed: 14 and 45 patients in the uncomplicated and complicated groups, respectively. The major complications were pancreatic fistulas (33%) and infections (22%). There were significant differences in: age, 74.0 (44 - 88) (P = 0.02); walking speed, 0.93 m/s (0.3 - 2.2) (P = 0.01); and fat mass, 16.50 kg (4.7 - 46.2) (P = 0.02), in the patients with complications. On Multivariable logistic regression analysis, age (odds ratio: 2.28; confidence interval (CI): 1.3400 - 569.00; P = 0.03), preoperative fat mass (odds ratio: 2.28; CI: 1.4900 - 168.00; P = 0.02), and walking speed (odds ratio: 0.119; CI: 0.0134 - 1.07; P = 0.05) were identified as risk factors. Walking speed (odds ratio: 0.119; CI: 0.0134 - 1.07; P = 0.05) was the risk factor that was extracted.

Conclusions: Older age, more preoperative fat mass, and decreased walking speed were possible risk factors for postoperative complications.

Keywords: Body composition; Complications; Pancreatic cancer; Walking speed.