Sakamoto Akimasa, Funamizu Naotake, Shine Mikiya, Uraoka Mio, Nagaoka Tomoyuki, Honjo Masahiko, Tamura Kei, Sakamoto Katsunori, Ogawa Kohei, Takada Yasutsugu
From the Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Ehime, Japan.
Pancreas. 2023 Mar 1;52(3):e196-e202. doi: 10.1097/MPA.0000000000002240.
Surgery plus adjuvant chemotherapy (AC) for resectable pancreatic ductal adenocarcinoma (PDAC) has been shown to prolong survival compared with surgery alone. Thus, it is of clinical importance that these patients receive a continuous dose of S-1. The aim of this study was to examine whether the geriatric nutritional risk index (GNRI) is a predictor for the completion of S-1 as AC for PDAC.
Seventy-seven patients who were administered S-1 as AC after pancreatectomy for PDAC between January 2010 and October 2021 were retrospectively enrolled. Predictive markers were statistically analyzed for S-1 completion, which was defined as continued oral administration with relative dose intensity of >80%.
Patients were divided into the S-1 complete group (n = 55; 71.4%) and S-1 incomplete group (n = 22; 28.6%). There was a significant association of higher GNRI ( P = 0.013) at the onset of AC with the completion of S-1. Receiver operating characteristic curve analysis revealed 94.4 as the optimal cutoff value of GNRI for predicting the completion of S-1. Univariate and multivariate analyses confirmed that GNRI >94.4 was independently associated with the completion of S-1 ( P = 0.007).
High GNRI value is a predictive marker for the completion of S-1 as AC for PDAC.
与单纯手术相比，可切除性胰腺导管腺癌（PDAC）采用手术加辅助化疗（AC）已被证明可延长生存期。因此，这些患者持续接受S-1治疗具有临床重要性。本研究的目的是探讨老年营养风险指数（GNRI）是否可作为PDAC辅助化疗中S-1完成情况的预测指标。
回顾性纳入2010年1月至2021年10月间因PDAC行胰腺切除术后接受S-1辅助化疗的77例患者。对S-1完成情况的预测指标进行统计学分析，S-1完成定义为相对剂量强度>80%的持续口服给药。
患者分为S-1完成组（n = 55；71.4%）和S-1未完成组（n = 22；28.6%）。辅助化疗开始时较高的GNRI（P = 0.013）与S-1的完成有显著相关性。受试者工作特征曲线分析显示，预测S-1完成的GNRI最佳临界值为94.4。单因素和多因素分析证实，GNRI>94.4与S-1的完成独立相关（P = 0.007）。
高GNRI值是PDAC辅助化疗中S-1完成情况的预测指标。
