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. 2022 Jan;24(1):112-126.
doi: 10.1007/s12094-021-02674-x. Epub 2021 Aug 7.

Clinical nutrition as part of the treatment pathway of pancreatic cancer patients: an expert consensus

A Carrato  1 , L Cerezo  2 , J Feliu  3 , T Macarulla  4 , E Martín-Pérez  5 , R Vera  6 , J Álvarez  7 , J I Botella-Carretero  8
Affiliations

Clinical nutrition as part of the treatment pathway of pancreatic cancer patients: an expert consensus

A Carrato et al. Clin Transl Oncol. 2022 Jan.

Abstract

Purpose: Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) into the comprehensive therapeutic management of PC patients.

Methods: A Spanish multidisciplinary group of specialists from the areas of Medical Oncology; Radiation Oncology; Endocrinology and Nutrition; and General Surgery agreed to assess the role of MNT as part of the best therapeutic management of PC patients.

Results: The panel established different recommendations focused on nutritional screening and nutritional screening tools, MNT strategies according to PC status, and MNT in palliative treatment.

Conclusions: There is an unmet need to integrate nutritional therapy as a crucial part of the multimodal care process in PC patients. Health authorities, health care professionals, cancer patients, and their families should be aware of the relevance of nutritional status and MNT on clinical outcomes and QoL of PC patients.

Keywords: Consensus; Enteral nutrition; Medical nutrition therapy; Nutritional screening; Pancreatic cancer; Parenteral nutrition.

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Conflict of interest statement

Alfredo Carrato has received honoraria from Roche, Merck, MSD, Servier, Bayer, Baxter, and BMS as collaboration in advisory boards. Honoraria from Baxter S.L. for his participation as consultant expert in the meeting. Dr Cerezo-Padellano has received honoraria for lectures and received travel support to attend educational meetings from Baxter Laboratories. Jaime Feliu has received consulting and advisory honoraria from Amgen, Ipsen, Eissai, Merck, Roche, Sirtex, and Novartis; research funding from Amgen and Merck. Honoraria from Baxter S.L. for his participation as consultant expert in the meeting. Dr Macarulla has received honoraria for lectures and received travel support to attend educational meetings from Baxter Laboratories. Dr Martín-Pérez has received honoraria for lectures and received travel support to attend educational meetings from Baxter Laboratories. Ruth Vera has received speaker honorarium from Roche, MERCK, Amgen, Merck Sharp & Dohme, Sanofi, and Bristol Myer Squibb, advisory honorarium from Roche, MERCK, Amgen, Merck Sharp & Dohme, and Sanofi. Honoraria from Baxter S.L. for her participation as consultant expert in the meeting. Julia Álvarez has received honoraria from Baxter S.L. for her participation as consultant expert in the meeting. Ignacio Botella has received honoraria from Baxter S.L. for his participation as consultant expert in the meeting.

Figures

Fig. 1
Fig. 1
The Malnutrition Universal Screening Tool (MUST). Reproduced here with the kind permission of BAPEN (British Association for Parenteral and Enteral Nutrition). The MUST was developed by the Malnutrition Advisory Group (MAG) of BAPEN and first produced in November 2003. The MUST has been validated for use in the hospital, community and care settings, the evidence base being contained in The MUST report. An Explanatory Booklet on MUST is also available for use in training and implementation. Copies of both the Report and Booklet are available from the BAPEN Office. Reference: http://www.bapen.org.uk/pdfs/must/must_full.pdf ‘Malnutrition Universal Screening Tool’ (MUST) or weight loss chart is reproduced here with the kind permission of BAPEN (British Association for Parenteral and Enteral Nutrition). For further information on ‘MUST’ see www.bapen.org.uk’
Fig. 2
Fig. 2
Integrating nutritional therapy within the treatment algorithm of resectable or borderline resectable pancreatic ductal adenocarcinoma. Gray triangle represents nutritional interventions and gray star represents assessment of nutritional therapy. *Fine-needle aspiration endoscopic ultrasound guidance or biopsy. **Chemotherapy ± radiation therapy or treatment as part of a clinical trial. CT chemotherapy
Fig. 3
Fig. 3
Integrating nutritional therapy within the treatment algorithm of the locally advanced pancreatic ductal adenocarcinoma. Gray triangle represents nutritional interventions and gray star represents assessment of nutritional therapy. *QT ± RT or treatment as part of a clinical trial. **See recommendations for nutritional intervention in surgery. CT chemotherapy, RT radiotherapy, PS performance status
Fig. 4
Fig. 4
Integrating nutritional therapy within the treatment algorithm of the metastatic pancreatic ductal adenocarcinoma. Gray triangle represents nutritional interventions and gray star represents assessment of nutritional therapy. *QT ± RT or treatment as part of a clinical trial. PS performance status
See this image and copyright information in PMC

References

    1. GBD 2017 Pancreatic Cancer Collaborators The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2019;4(12):934–947. doi: 10.1016/S2468-1253(19)30347-4. - DOI - PMC - PubMed
    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021 doi: 10.3322/caac.21660. - DOI - PubMed
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Spanish Society of Medical Oncology [Cancer figures in Spain in 2021 year]. https://seom.org/images/Cifras_del_cancer_en_España_2021.pdf. Accessed 14 May 2021
    1. McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS. Pancreatic cancer: a review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018;24(43):4846–4861. doi: 10.3748/wjg.v24.i43.4846. - DOI - PMC - PubMed

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