Abstract
Background
Treatment with somatostatin analogues (SSAs) or pancreaticoduodenectomy frequently
causes malnutrition-inducing pancreatic exocrine insufficiency. This single-centre
retrospective cohort study aimed to establish whether pancreatic enzyme replacement
therapy (PERT) improves survival or nutritional status in SSA or pancreaticoduodenectomy-treated
patients with pancreatic neuroendocrine tumours (pNETs).
Methods
SSA and/or pancreaticoduodenectomy-treated patients with pNETs, diagnosed between
2009 and 2019, (n = 77) were retrospectively identified from departmental databases.
Data was sourced from clinical records. Overall survival and percentage monthly weight
changes were compared between PERT-treated (n = 45) and non-PERT-treated (n = 32)
patients.
Results
PERT-treated patients experienced significantly greater median monthly weight gain
(+0.01% vs −0.10%, p = 0.038) and 5-year survival (81% vs 51%, p = 0.007). PERT was
not, however, independently associated with survival (Hazard ratio 0.47, 95% CI 0.14–1.62,
p = 0.232). Considering SSA-treated patients (n = 50) only, PERT-treated patients
(n = 24) showed numerically but non-significantly improved monthly weight gain (+0.04%
vs −0.18%, p = 0.139) and median survival (55.5, 95% CI 10.2–100.7 vs 42.4, 95% CI
11.7–73.2 months, p = 0.082).
Conclusion
PERT may improve survival and nutrition in SSA and pancreaticoduodenectomy-treated
patients with pNETs, however, low patient numbers precluded the reliable mitigation
of confounding in this study. A further multi-centre study is required to define the
benefits of PERT in this population.
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Article info
Publication history
Published online: June 15, 2022
Accepted:
June 9,
2022
Received:
November 8,
2021
Footnotes
☆This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2022 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
