Maria Q.B. Petzel

Influence of Obesity on Cancer-Related Outcomes After Pancreatectomy to Treat Pancreatic Adenocarcinoma

OBJECTIVE To examine the influence of obesity, as measured by body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared), on clinicopathologic factors and survival after pancreatectomy to treat adenocarcinoma. DESIGN Retrospective review and statistical analysis using prospectively collected data. SETTING Referral center with a dedicated multidisciplinary pancreas cancer program. PATIENTS Two hundred eighty-five consecutive patients with data available for BMI calculation who underwent potentially curative pancreas resection to treat adenocarcinoma from January 1, 1999, to October 31, 2006. MAIN OUTCOME MEASURE Influence of BMI and other known prognostic variables on the incidence of lymph node metastasis and disease-free and overall survival. RESULTS We identified a subset of obese patients (BMI >35) who were at 12-fold risk of lymph node metastasis compared with nonobese patients (BMI < or =35). The estimated disease-free and overall survival rates were decreased in the obese patients, and the risk of cancer recurrence and death after pancreatectomy was nearly twice that in nonobese patients. CONCLUSIONS Obese patients with a BMI of more than 35 are more likely to have node-positive pancreatic cancer and decreased survival after surgical resection. Data suggest that the negative influence of BMI of more than 35 on cancer-related end points is unrelated to the potential complexity of performing major oncologic surgery in obese patients.

Impact of pancreatectomy on long‐term patient‐reported symptoms and quality of life in recurrence‐free survivors of pancreatic and periampullary neoplasms

Long term patient‐reported symptoms and quality of life (QOL) are important outcome metrics following cancer operations, but have been poorly described in patients who have previously undergone pancreatectomy.

Poster 68 Feasibility of a Prehabilitation Program for Patients with Potentially Resectable Pancreatic Cancer: Pilot Study

over the 4-year period. Pressure ulcer incidence and healing rate were reviewed by multidisciplinary team. Setting: A 90-bed acute rehabilitation institute affiliated with medical school. Participants: All admissions from 2012 through 2015. Interventions: Risk assessment, tracking system, staff and patient education, supplies accessibility, wound rounds, therapeutic surfaces, positioning, unit-based skin champions, orthotic assessment, nutritional management, performance monitoring and reporting, treatment guidelines. Main Outcome Measures: Pressure ulcer incidence per 1000 patient days, and healing rate of existing pressure ulcer each year from 2012 through 2015. Results: Pressure ulcer incidence was reduced by 50% in 2012 following the initiation of the multidisciplinary program, and maintained at 0-0.09 through the following years. Pressure ulcer healing rate was 76.92% in 2012, increased to 97.15% in 2013 after improvement in assessment/tracking system, staff/patient education, nutritional assessment, treatment supplies accessibility and collaboration with physicians. In 2014 we found no significant improvement after implementation of safe patient handling equipment and surfacing modification. In late 2014 we started developing the skin champions who were experts on skin care and acted as resources for their peers, we also enhanced multidisciplinary team with involvement of prosthetic and orthotic clinic to evaluate and adjust braces and casts. In 2015 healing rate reached 98.04%. Conclusions: Pressure ulcer prevention and treatment in acute rehabilitation represent a challenging problem. Successful implementation of a multidisciplinary team is crucial for effectively reducing pressure ulcer incidence, improving healing process, ensuring maximal functional gain and reasonable length of stay in acute rehabilitation centers. Level of Evidence: Level I