Pre-Operative Markers of Post-Operative Complications in Pancreatic Cancer Patients: A Single-Center Study.

Abstract

Purpose: Pancreatic cancer remains a deadly disease with a low survival rate specifically if diagnosed at later stages. Surgery is one of the mainstay treatments for early stage disease but is accompanied by significant mortality and morbidity even in high volume centers. In the present study we wanted to determine the influence of pre-operative weight loss, BMI and liver function tests on postoperative outcomes.

Methods: Data for patients who underwent pancreatic surgery at the American University of Beirut Medical Center between 1998 and 2017 were analyzed. The data included patient demographics, pathologic diagnosis, stage, nodal involvement, tumor grade, surgical margin, type of adjuvant therapy, liver function tests and post-operative complications. The correlation and p-value were determined by the chi-square test with p-value < 0.05 considered statistically significant.

Results: The analysis included 236 patients. 63% were males and mean age was 60 years. A total of 96 (41%) patients had significant weight loss prior to surgery and 173 (31%) had a BMI > 30 kg/m2 which were considered obese. Obesity and significant weight loss were associated with increased risk of post-operative complications (P = 0.013 and P = 0.004, respectively). Transaminases and cholestatic liver enzymes were not associated with post-operative complications.

Conclusions: Assessment and management of nutritional status particularly weight loss and BMI prior to pancreatic cancer surgery may influence postoperative outcomes in this patient population.