Initial Examination of the Result of Prehabilitation Of The Outcome Of Prehabilitation On Muscle Mass, Weight, And Dietary Consumption Stratified By Hand Grip Strength In Pancreatic Cancer Patients

Muhammad Bilal, Rabia Adil, Maryam Iqbal

Abstract


This intervention before surgery has been termed prehabilitation. The one known cure to pancreatic cancer is surgery. The most common surgery for pancreatic cancer, pancreaticoduodenectomy, has the highest complication rate which is why the focus was on this type of surgery. Early nutrition education and exercise intervention prior to surgery has been looked at in other types of cancers, although it has yet to be studied in pancreatic cancer patients. This is part of a larger study looking at prehabilitation on quality of life. This specific study is the preliminary analysis looking at the effect of the intervention on weight, muscle mass, and dietary intake.

 

This study looked at 24-Hour Recall and BIA analysis at baseline and 1 month post-surgery for individuals undergoing a pancreaticoduodenectomy. Results were also analyzed following post hoc group assignments based on baseline hand grip strength. Comparisons were made to determine if nutrition education during the prehabilitation phase was beneficial overall. This is a preliminary analysis for a larger study to help better assess if further stratification needs to occur for intervention.


Keywords


prehabilitation, muscle mass, weight, dietary consumption, hand grip strength, pancreatic cancer patients

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References


National Cancer Institute. [cited 2016 8/20/2016]; Available from: http://seer.cancer.gov/statfacts/html/pancreas.html.

Society, A.C. Signs and symptoms of pancreatic cancer. 2016 May 31, 2016 [cited 2017 4/1/2017]; Available from: https://www.cancer.org/cancer/pancreatic-cancer/detection-diagnosis-staging/signs-and-symptoms.html.

National Cancer Institute. [cited 2017 4/12/2017]; Available from: http://seer.cancer.gov/.

National Cancer Institute. [cited 2017 4/01/2017]; Available from: http://seer.cancer.gov/statfacts/html/pancreas.html.

Pancreatic cancer-patient version. [cited 2015 10/19/2015]; Available from: http://www.cancer.gov/types/pancreatic.

Ong, H.S., Ng, E.H. Heng, G., Soo, K.C. Pancreaticoduodenectomy with pancreaticogastrostomy assessment of patients' nutritional status, quality of life and pancreatic exocrine function. Aust. N. Z. Surg, 2000. 70: p. 199-203.

Pappas, S., Krzywda, E., Mcdowell, N. Nutrition and pancreaticoduodenectomy. Nutrition in Clinical Practice, 2010. 25(3): p. 234-243.

Whipple, A., The rationale of radical surgery for cancer of the pancreas and ampullary region. Annals of Surgery. 1941. 114(4).

Ferrara, M.J., Lohse, C., Kudva, Y.C., Farnell, M.B., Que, F.G., Reid-Lombardo, K.M., Donohue, J.H., Nagorney, D.M., Chari, S.T., Vege, S.S., Kendrick, M.L. Immediate post resection diabetes mellitus after pancreaticoduodenectomy: incidence and risk factors. HPB. 2013. 15(3).

Aslani, A., Gill, A.J., Roach, P.J., Allen, B.J., Smith, R.C. Preoperative body composition is influenced by the stage of operable pancreatic adenocarcinoma but does not predict survivial after whipple's procedure. HPB. 12: p. 325-333.

Zgodzinski, W., Dekoj, T., Espat, N.J. Understanding clinical issues in postoperative nutrition after pancreaticoduodenectomy. Nutrition in Clinical Practice. 2005. 20: p. 654-661.

Rubin, R., Surgical wound infection: epideiology, pathogenesis, diagnosis, and management. BMC Infectious Diseases. 2006. 6(171).

Ho, C.K., Kleeff, J., Friess, H., Buchler, M.W. Complications of pancreatic surgery. HPB. 2005. 7(2).

Machado, N., Pancreatic fistula after pancreatectomy: Definitions, risk factors, preventative measures, and management- review. Journal of Surgical Oncology. 2011. 2012.

Geibel, J. Abdominal hernias. 2016 [cited 2017 4/1/2017]; Available from: http://emedicine.medscape.com/article/189563-overview.

Schafer, M., Clavien, P.A. Evidence-based pancreatic head resection for pancreatic cancer and chronic pancreatitis. Ann Surg. 202. 236(2): p. 137-148.

Staff, M.C. Gastroparesis. 2014 [cited 2017 4/1/2017]; Available from: http://www.mayoclinic.org/diseases-conditions/gastroparesis/basics/definition/con-20023971.

MedlinePlus. Malabsorption. 2017 3/09/2017 [cited 2017 4/1/2017]; Available f rom: https://medlineplus.gov/ency/article/000299.htm.

MedlinePlus. Dumping syndrome. 2016 3/3/2016 [cited 2017 4/12/2017]; Available from: http://emedicine.medscape.com/article/173594-overview#a6.

Staff, M.C. Dumping syndrome. 2015 [cited 2017 4/3/2017]; Available from: http://www.mayoclinic.org/diseases-conditions/dumping-syndrome/basics/definition/con-20028034.

Caro, M.M.M, Laviano, A., Pichard, C. Nutritional intervention and quality of life in adult oncology patients. Clinical Nutrition. 2007. 26: p. 289-301.

Tan, B.H.L., Birdsell, L.A., Martin, L., Baracos, V.E., Fearon, K.C.H. Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res, 2009. 15(22).

Ravasco, P., Monteriro-Grillo, I., Vidal, P.M., Camilo, M.E. Dietary counseling improves patient outcomes: A prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. Journal of Clinical Oncology. 2005. 23(7): p. 1431-1438.

National Cancer Institute at the National Institutes of Health. Cancer.gov. [cited 2015 10/19/2015]; Available from: http://www.cancer.gov/types/pancreatic.

van Venrooij, L.M.W., de Vos, R., Zijlsta, E., Borgmeijer-Hoelen, M.M.M.J., van Leeuwen, P.A.M., de Mol, B.A.J.M., The impact of low preoperative fat-free body mass on infections and length of stay after cardiac surgery: A prospective cohort study. The Journal of Thoracic and Cardiovascular Surgery. 2011. 142(5): p. 1263-1269.

Chaston, T.B., O'Brien, P.E. Changes in fat-free mass during significant weight loss: A systematic review. Interantional Journal of Obesity. 2006. 31: p. 743-750.

Marcell, T., Sarcopenia: Causes, consequences, and prevention. Journal of

Gerontology. 2003. 58(10): p. 911-916.

Bachmann, J., Krakowski-Roosen, H., Buchler, M.W., Friess, H., Martignoni, M.E. Cachexia worsens prognosis in patients with resectable pancreatic cancer. J Gastrointest Surg. 2007. 12: p. 1193-1201.

Thomas, D. Loss of skeletal muscle mass in aging: examining the relationship of starvation, sarcopenia, and cachexia. European Society for Clinical Nutrition and Metabolism. 2007.

Russell, M.K., Functional assessment of nutrition status. Nutrition in Clinical Practice. 2015. 30(2): p. 211-218.

Norman, K., Stobaus, N., Smoliner, C., Zocher, D., Scheufele, R., Valentini L., Lochs, H., Pirlich, M. Determinants of hand grip strength, knee extension strength and functional status in cancer patients. Clinical Nutrition. 2010. 29(2010): p.

-591.

White, J.W., Jensen, J., et al., Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Characteristics recommended for identification and documentation of adult malnutrition (undernutrition). J Acad Nutr Diet. 2012. 112: p. 730-738.

Mendes, J., Amaral, T. Handgrip strength at admission and time to discharge in medical and surgical inpatients. J Parenter Enteral Nutr. 2014. 38: p. 481-488.

Lou, N., Chi, C.C., Chen, X.D., Zhou, C.J., Wang, S.L., Zhuang, C.L., Shen, X. Sarcopenia in overweight and obese patients is a predictive factor for postoperative complication in gastric cancer: A prospective study. Eur J Surg Oncol. 2016: p. 1-8.

Gillis, C., Li, C., Lee, L., Awasthi, R., Augustin, B., Gamsa, A., Liberman, A.S., Stein, B., Charlebois, P., Feldman, L.S., Carli, F. Prehabilitation versus rehabilitation; A randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014. 121: p. 937-947.

Ravasco, P., Grillo, I. M., Camilo, M. Cancer wasting and quality of life react to early individualized nutritional counselling. Clinical Nutrition. 2007. 26: p. 7-15.

Laky, B., Janda, M., Kondalsamy-Chennakesavan, S., Cleghorn, G., Obermair, A. Pretreatment malnutrition and quality of life-association withpProlonged length of hospital stay among patients with gynecological cancer: A cohort study. BMC Cancer. 2010. 10(232).

Ravasco, P., Nutritional approaches in cancer: Relevance of individualized

counseling and supplementation. Nutrition. 2015. 31: p. 603-604.

Barber, M., The pathophysiology and treatment of cancer cachexia. Nutr Clin Pract. 2002. 17(203-209): p. 203.

Esper, D., et al. The cancer cachexia syndrome: a review of metabolic and clinical

manifestations. Nutr Clin Pract. 2005. 20: p. 369-376.

De Wys, W.D., et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med. 1980. 69: p. 491-497.

Andreyev, H., et al. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1988. 34: p. 503-509.

Ravasco, P., et al. Nutritional deterioration in cancer: the role of disease and diet.

Clin Oncol. 2003. 15: p. 443-450.

Rolyan, S.P., JAMAR Hydraulic Hand Dynamometer owner's manual. Jamar Booklet. 2013. 3.

24-Hour Recall. [cited 2016 July 28, 2016]; Available from: https://dietassessmentprimer.cancer.gov/profiles/recall/.

BIA Analysis. [cited 2016 August 28, 2016]; Available from: https://consensus.nih.gov/1994/1994bioelectricimpedancebodyta015html.htm.

Kyle, U.G., Bosaeus, I., De Lorenzo, A.D., Deurenberg, P., Elia, M., Gomex, J.M., Heitmann, B.L., Kent-Smith, L., Melchior, J.C., Pirlich, M., Scharfetter, H., Schols, A.M.W.J., Pichard, C. Bioelectrical Impedance Analysis-Part 1: Review of Principles and Methods. Clinical Nutrition. 2004. 23: p. 1226-1243.

Kyle, U.G., Bosaeus, I., De Lorenzo, A.D., Deurenberg, P., Elia, M., Gomex, J.M., Heitmann, B.L., Kent-Smith, L., Melchior, J.C., Pirlich, M., Scharfetter, H., Schols, A.M.W.J., Pichard, C. Bioelectrical impedance analysis-Part 2: Utilization in clinical practice. Clinical Nutrition. 2004. 23: p. 1430-1453.

Holdoway, A., High protein nutritional support. CN Focus. 2013. 6(3): p. 59-61.

Bauer, J., Cederhold, T., Cesari, M., Crus-Jentoft, A.J., Morley, J.E., Phillips, S., Sieber, C., Stehle, P., Teta, D., Visvanthan, R., Volpi, E., Boirie, Y. Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the PROT-AGE Study Group. JAMDA. 2013. 14: p. 542-559.

Nestle Health-Beneprotein. [cited 2015 11/02/2015]; Available from: https://www.nestlehealthscience.us/brands/beneprotein/beneprotein-hcp.

Beneprotein-Impact AR. [cited 2015 11/02/2015]; Available from: https://www.nestlehealthscience.us/brands/impact/impact-advanced-recovery-hcp.


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