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 

机构地区：[1]Section of Oncology,Department of Medicine,Pancreas Institute,University of Verona Hospital Trust,Verona 37126,Italy [2]Scuola di Specializzazione in Scienza dell’Alimentazione,Universitàdi Roma Tor Vergata,Roma 00133,Italy [3]UOC Nutrizione Clinica,Dipartimento di Scienze Mediche e Chirurgiche,Fondazione Policlinico A.Gemelli IRCCS,Roma 00168,Italy [4]Dipartimento di Medicina e Chirurgia Traslazionale,UniversitàCattolica del Sacro Cuore,Roma 00168,Italy [5]General and Pancreatic Surgery Unit,Pancreas Institute,University of Verona Hospital Trust,Verona 37126,Italy [6]Oncologia Medica Unit,Comprehensive Cancer Center,Fondazione Policlinico Universitario A Gemelli IRCCS,Roma 00167,Italy [7]Oncologia Medica Unit,UniversitàCattolica del Sacro Cuore,Roma 00168,Italy [8]Digestive Surgery Unit and Pancreatic Surgery Gemelli Center Director,Fondazione Policlinico Universitario A Gemelli IRCCS,Roma 00167,Italy [9]UOC di Medicina Interna e Gastroenterologia,Dipartimento di Scienze Mediche e Chirurgiche,Fondazione Policlinico Universitario A Gemelli IRCCS,Roma 00167,Italy [10]UOSD Nutrizione Avanzata in Oncologia,Dipartimento di Scienze Mediche e Chirurgiche,Fondazione Policlinico Universitario A Gemelli IRCCS,Roma 00167,Italy

出　　处：《World Journal of Gastrointestinal Surgery》2021年第9期885-903,共19页世界胃肠外科杂志（英文版）（电子版）

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.

关 键 词：Pancreatic cancer Neoadjuvant treatment Pancreatic cancer surgery Nutritional status Nutritional prehabilitation MALNUTRITION 

分 类 号：R735.9[医药卫生—肿瘤]