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

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

作者机构：Section of OncologyDepartment of MedicinePancreas InstituteUniversity of Verona Hospital TrustVerona 37126Italy Scuola di Specializzazione in Scienza dell’AlimentazioneUniversitàdi Roma Tor VergataRoma 00133Italy UOC Nutrizione ClinicaDipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico A.Gemelli IRCCSRoma 00168Italy Dipartimento di Medicina e Chirurgia TraslazionaleUniversitàCattolica del Sacro CuoreRoma 00168Italy General and Pancreatic Surgery UnitPancreas InstituteUniversity of Verona Hospital TrustVerona 37126Italy Oncologia Medica UnitComprehensive Cancer CenterFondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy Oncologia Medica UnitUniversitàCattolica del Sacro CuoreRoma 00168Italy Digestive Surgery Unit and Pancreatic Surgery Gemelli Center DirectorFondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy UOC di Medicina Interna e GastroenterologiaDipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy UOSD Nutrizione Avanzata in OncologiaDipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第9期

页      面：885-903页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Pancreatic cancer Neoadjuvant treatment Pancreatic cancer surgery Nutritional status Nutritional prehabilitation Malnutrition 

摘      要：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.