A prospective cohort study of dietary intake and clinical-nutritional biomarkers in patients with periampullary malignancies undergoing pancreatoduodenectomy in Southeast Brazil.
4 affiliations
- 1Division of Clinical Nutrition, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil. [email protected].
- 2Division of Digestive Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil.
- 3Division of Epidemiology and Statistics, Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil.
- 4Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil.
Abstract
Purpose
Patients undergoing pancreatoduodenectomy for periampullary malignancies are at high nutritional risk. The aim was to characterize longitudinal changes in reported dietary intake, clinical-nutritional biomarkers, and inflammatory-nutritional indices after surgery and contextualize them through cross-sectional comparisons with age- and sex-similar controls.Methods
This prospective longitudinal cohort included 24 patients and 20 contextual controls. Patients were assessed preoperatively and at 3 and 6 months after discharge; controls were assessed once. Dietary intake was estimated using an adapted food frequency questionnaire (FFQ). FFQ-reported energy surplus was intake minus the 25 kcal/kg/day requirement based on the European Society for Clinical Nutrition and Metabolism (ESPEN). Longitudinal analyses, contextual comparisons, and exploratory adjusted diet-biomarker regressions were performed.Results
Of 24 patients assessed preoperatively, 18 and 16 were reassessed at 3 and 6 months. Median reported energy intake decreased from 2625 to 2011 and 1948 kcal/day, respectively. FFQ-reported energy surplus and intakes of macronutrients, fiber, calcium, iron, and selenium decreased, whereas zinc and vitamins A and E showed no detected longitudinal change. C-reactive protein, ferritin, liver enzymes, and serum vitamin E decreased. Glasgow Prognostic Score (GPS) and C-reactive protein-to-albumin ratio (CAR) decreased, the C-reactive protein-albumin-lymphocyte (CALLY) index increased, and the Prognostic Nutritional Index (PNI) showed no detected longitudinal change. Diet-biomarker associations were limited and inconsistent, although iron intake was positively associated with hemoglobin preoperatively in both adjusted models.Conclusion
During the first 6 months after pancreatoduodenectomy, reduced reported dietary intake persisted despite attenuation of systemic inflammation, while biochemical and inflammatory-nutritional indices followed divergent trajectories. These trajectories describe patients alive and available for follow-up.
Related
- Survival impact of involvement of lymph node stations 16b1, 9, and 8a during pancreatoduodenectomy for pancreatic and periampullary cancers (PANODE): prospective multicentre study.
- Outcomes following Pancreatoduodenectomy in Patients ≥80 Years: An Analysis of the Prospective Pancreas Registry of the German Society for General and Visceral Surgery (DGAV|Registry Pancreas).
- Pan-European Training Program for Robotic Pancreatoduodenectomy (LEARNBOT): Prospective Multicenter Study on Feasibility and Outcome.
- Construction of a multidisciplinary perioperative nutritional management scheme for endoscopic therapy in patients with biliary tract malignancies
- Prognostic scores and biomarkers in hematologic malignancies: current evidence and future perspectives
BibTeX
@article{ribeiro2026prospective,
title = {{A prospective cohort study of dietary intake and clinical-nutritional biomarkers in patients with periampullary malignancies undergoing pancreatoduodenectomy in Southeast Brazil.}},
author = {Marco Aurélio Ribeiro and José Sebastião Dos Santos and Gleici da Silva Castro Perdoná and Anderson Marliere Navarro},
journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer},
year = {2026},
month = oct,
doi = {10.1007/s00520-026-11357-8},
url = {https://europepmc.org/article/MED/42905299},
note = {CC BY},
}
RIS
TY - JOUR
TI - A prospective cohort study of dietary intake and clinical-nutritional biomarkers in patients with periampullary malignancies undergoing pancreatoduodenectomy in Southeast Brazil.
AU - Marco Aurélio Ribeiro
AU - José Sebastião Dos Santos
AU - Gleici da Silva Castro Perdoná
AU - Anderson Marliere Navarro
PY - 2026
DA - 2026/10/21
JO - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
DO - 10.1007/s00520-026-11357-8
UR - https://europepmc.org/article/MED/42905299
AB - Purpose Patients undergoing pancreatoduodenectomy for periampullary malignancies are at high nutritional risk. The aim was to characterize longitudinal changes in reported dietary intake, clinical-nutritional biomarkers, and inflammatory-nutritional indices after surgery and contextualize them through cross-sectional comparisons with age- and sex-similar controls.Methods This prospective longitudinal cohort included 24 patients and 20 contextual controls. Patients were assessed preoperatively and at 3 and 6 months after discharge; controls were assessed once. Dietary intake was estimated using an adapted food frequency questionnaire (FFQ). FFQ-reported energy surplus was intake minus the 25 kcal/kg/day requirement based on the European Society for Clinical Nutrition and Metabolism (ESPEN). Longitudinal analyses, contextual comparisons, and exploratory adjusted diet-biomarker regressions were performed.Results Of 24 patients assessed preoperatively, 18 and 16 were reassessed at 3 and 6 months. Median reported energy intake decreased from 2625 to 2011 and 1948 kcal/day, respectively. FFQ-reported energy surplus and intakes of macronutrients, fiber, calcium, iron, and selenium decreased, whereas zinc and vitamins A and E showed no detected longitudinal change. C-reactive protein, ferritin, liver enzymes, and serum vitamin E decreased. Glasgow Prognostic Score (GPS) and C-reactive protein-to-albumin ratio (CAR) decreased, the C-reactive protein-albumin-lymphocyte (CALLY) index increased, and the Prognostic Nutritional Index (PNI) showed no detected longitudinal change. Diet-biomarker associations were limited and inconsistent, although iron intake was positively associated with hemoglobin preoperatively in both adjusted models.Conclusion During the first 6 months after pancreatoduodenectomy, reduced reported dietary intake persisted despite attenuation of systemic inflammation, while biochemical and inflammatory-nutritional indices followed divergent trajectories. These trajectories describe patients alive and available for follow-up.
SN - 0941-4355
SN - 1433-7339
ER -