Consensus guidelines are required for the peri operative nutritional assessment and management of patients who undergo surgical resection for suspected pancreatic cancer

Abstract

Thomas B Russell, Somaiah Aroori

Surgical resection remains the only treatment option for patients with pancreatic cancer who wish to achieve long-term survival. Despite recent advances, this is associated with considerable morbidity and mortality. Surgical candidates are frequently malnourished, and this is known to negatively affect outcomes. Despite this, the nutritional assessment and management of pancreatic cancer patients remains highly variable and there is no consensus. We argue that a specialist nutrition professional should be involved pre-operatively to optimise outcomes and to identify patients who require additional support. Micronutrient deficiencies are common amongst surgical candidates; it is unknown whether this affects outcomes. Furthermore, it is unknown if correcting deficiencies is of benefit. Robust studies are required to investigate this. Finally, there is limited evidence to support the use of prehabilitation in pancreatic surgery, but this is starting to emerge. The present short communication aims to review the recent literature and comment on the above issues.

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