{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:01:57Z","timestamp":1792008117135,"version":"4.4.0"},"reference-count":112,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>In this review, we define \u201cmalnutrition\u201d according to the Global Leadership Initiative on Malnutrition (GLIM) criteria (phenotypic and etiologic components) and \u201ccachexia\u201d as a multifactorial syndrome characterized by progressive skeletal muscle loss\u2014unresponsive to conventional nutrition\u2014and systemic inflammation (e [...]<\/jats:p>","DOI":"10.3390\/curroncol32090519","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T11:00:00Z","timestamp":1758106800000},"page":"519","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Nutritional Status and Chemotherapy Completion in Resectable Pancreatic Cancer: A Narrative Review"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6076-6516","authenticated-orcid":false,"given":"Naotake","family":"Funamizu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon-City 791-0295, Ehime Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mio","family":"Uraoka","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon-City 791-0295, Ehime Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon-City 791-0295, Ehime Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miku","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon-City 791-0295, Ehime Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8042-1486","authenticated-orcid":false,"given":"Akimasa","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon-City 791-0295, Ehime Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0041-3298","authenticated-orcid":false,"given":"Yoshiaki","family":"Kamei","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon-City 791-0295, Ehime Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzo","family":"Umeda","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon-City 791-0295, Ehime Prefecture, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clnu.2018.08.002","article-title":"GLIM criteria for the diagnosis of malnutrition\u2014A consensus report from the global clinical nutrition community","volume":"38","author":"Cederholm","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1016\/j.clnu.2023.11.026","article-title":"Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach","volume":"43","author":"Cederholm","year":"2024","journal-title":"Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/S1470-2045(10)70218-7","article-title":"Definition and classification of cancer cachexia: An international consensus","volume":"12","author":"Fearon","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_4","first-page":"12","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3385","DOI":"10.1016\/j.clnu.2020.02.029","article-title":"Nutritional and immune impairments and their effects on outcomes in early pancreatic cancer patients undergoing pancreatoduodenectomy","volume":"39","author":"Tumas","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"M\u0119kal, D., Sobocki, J., Badowska-Kozakiewicz, A., Cise\u0142, B., Ruci\u0144ska, M., Kokoszka-Bargie\u0142, I., Cybulski, M., Guzi\u0144ska-Ustymowicz, K., Kraj, L., and Ka\u017amierczak-Siedlecka, K. (2023). Evaluation of Nutritional Status and the Impact of Nutritional Treatment in Patients with Pancreatic Cancer. Cancers, 15.","DOI":"10.3390\/cancers15153816"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Menozzi, R., Valoriani, F., Ballarin, R., Fontana, A., Giacobazzi, P., Spaggiari, M., Brunocilla, E., Gaf\u00e0, R., Faccioli, N., and D\u2019Amico, G. (2023). Impact of nutritional status on postoperative outcomes in cancer patients following elective pancreatic surgery. Nutrients, 15.","DOI":"10.3390\/nu15081958"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zhao, P., Wu, Z., Wang, Z., Feng, J., Chen, J., Li, Y., Zhou, Y., Xu, L., Liu, Y., and Huang, L. (2022). Prognostic role of the prognostic nutritional index in patients with pancreatic cancer who underwent curative resection without preoperative neoadjuvant treatment: A systematic review and meta-analysis. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.992641"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Grinstead, C., and Yoon, S.L. (2025). Geriatric Nutritional Risk Index (GNRI) and Survival in Pancreatic Cancer: A Retrospective Study. Nutrients, 17.","DOI":"10.3390\/nu17030509"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1245\/s10434-014-4280-7","article-title":"Postoperative serum albumin level is a marker of incomplete adjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma","volume":"22","author":"Matsumoto","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Morita, Y., Sakaguchi, T., Kitajima, R., Furuhashi, S., Kiuchi, R., Takeda, M., Hiraide, T., Shibasaki, Y., Kikuchi, H., and Konno, H. (2019). Body weight loss after surgery affects the continuity of adjuvant chemotherapy for pancreatic cancer. BMC Cancer, 19.","DOI":"10.1186\/s12885-019-5621-5"},{"key":"ref_12","unstructured":"(2025, August 09). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae): Pancreatic Adenocarcinoma. Version 2.2025. National Comprehensive Cancer Network. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/pancreatic.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: Clinical nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1001\/jama.297.3.267","article-title":"Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: A randomized controlled trial","volume":"297","author":"Oettle","year":"2007","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1056\/NEJMoa1809775","article-title":"FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer","volume":"379","author":"Conroy","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S0140-6736(16)32409-6","article-title":"Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): A multicentre, open-label, randomized, phase 3 trial","volume":"389","author":"Neoptolemos","year":"2017","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/S0140-6736(16)30583-9","article-title":"Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: A phase III, open-label, randomised, non-inferiority trial (JASPAC 01)","volume":"388","author":"Uesaka","year":"2016","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1093\/jjco\/hyy190","article-title":"Randomized phase II\/III trial of neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer (Prep-02\/JSAP-05)","volume":"49","author":"Motoi","year":"2019","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_19","first-page":"e196","article-title":"Geriatric nutritional risk index predicts tolerability of S-1 as adjuvant chemotherapy for pancreatic ductal adenocarcinoma","volume":"52","author":"Sakamoto","year":"2023","journal-title":"Pancreas"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Funamizu, N., Sakamoto, A., Mori, S., Iwata, M., Shine, M., Ito, C., Uraoka, M., Ueno, Y., Tamura, K., and Kamei, Y. (2025). Postoperative geriatric nutritional risk index as a determinant of tolerance to S-1 adjuvant chemotherapy after curative surgery for pancreatic ductal adenocarcinoma: A cohort study with external validation. Cancers, 17.","DOI":"10.3390\/cancers17091448"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"922","DOI":"10.3390\/cancers16050922","article-title":"C-reactive protein-to-albumin ratio to predict tolerability of S-1 as an adjuvant chemotherapy in pancreatic cancer","volume":"16","author":"Funamizu","year":"2024","journal-title":"Cancers"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3372","DOI":"10.3390\/cancers16193372","article-title":"C-reactive protein-to-albumin ratio as a predictive indicator for evaluating tolerability in S-1 adjuvant chemotherapy after curative surgery for pancreatic cancer: An external validation cohort study","volume":"16","author":"Funamizu","year":"2024","journal-title":"Cancers"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"108650","DOI":"10.1016\/j.ejso.2024.108650","article-title":"Preoperative nutritional status is a useful predictor of the feasibility of postoperative treatment in octogenarian-plus pancreatic ductal adenocarcinoma patients","volume":"50","author":"Yamada","year":"2024","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Funamizu, N., Sakamoto, A., Utsunomiya, T., Uraoka, M., Nagaoka, T., Iwata, M., Ito, C., Tamura, K., Sakamoto, K., and Ogawa, K. (2022). Geriatric nutritional risk index as a potential prognostic marker for patients with resectable pancreatic cancer: A single-center, retrospective cohort study. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-18077-z"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1038\/s41430-018-0155-5","article-title":"Prognostic impact of early nutritional support in patients affected by locally advanced and metastatic pancreatic ductal adenocarcinoma undergoing chemotherapy","volume":"72","author":"Trestini","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.pan.2018.10.010","article-title":"Enzyme replacement improves survival among patients with pancreatic cancer: Results of a population based study","volume":"19","author":"Roberts","year":"2019","journal-title":"Pancreatology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1136\/gut.42.1.92","article-title":"Placebo controlled trial of enteric coated pancreatin microsphere treatment in patients with unresectable cancer of the pancreatic head region","volume":"42","author":"Bruno","year":"1998","journal-title":"Gut"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Moore, J.V., Scoggins, C.R., Philips, P., Egger, M.E., and Martin, R.C.G. (2024). Optimization of exocrine pancreatic insufficiency in pancreatic adenocarcinoma patients. Nutrients, 16.","DOI":"10.3390\/nu16203499"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.1007\/s10147-021-01958-0","article-title":"Impact of Preoperative Nutritional Support and Rehabilitation Therapy in Patients Undergoing Pancreaticoduodenectomy","volume":"26","author":"Tsukagoshi","year":"2021","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Nakaoka, K., Ohno, E., Kuramitsu, K., Kuzuya, T., Funasaka, K., Tochio, T., Fujii, T., Takahashi, H., Kondo, N., and Miyahara, R. (2024). Efficacy of 1-Kestose Supplementation in Patients with Pancreatic Ductal Adenocarcinoma: A Randomized Controlled Pilot Study. Nutrients, 16.","DOI":"10.3390\/nu16172889"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.surg.2024.04.024","article-title":"The Impact of Goal-Directed Prehabilitation Therapy on Functional Capacity in Patients Undergoing Hepatobiliary and Pancreatic Surgery: A Randomized Clinical Trial","volume":"176","author":"Mizuno","year":"2024","journal-title":"Surgery"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.surg.2018.05.040","article-title":"Nutritional support and therapy in pancreatic surgery: A position paper of the International Study Group on Pancreatic Surgery (ISGPS)","volume":"164","author":"Gianotti","year":"2018","journal-title":"Surgery"},{"key":"ref_33","first-page":"4009","article-title":"The Role of Interleukin-6 Family Cytokines in Cancer Cachexia","volume":"291","author":"Agca","year":"2024","journal-title":"FEBS J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13045-023-01454-0","article-title":"Cancer cachexia: Molecular mechanisms and treatment strategies","volume":"16","author":"Setiawan","year":"2023","journal-title":"J. Hematol. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"24400","DOI":"10.1021\/acs.jafc.4c04456","article-title":"Butyrate inhibits the HDAC8\/NF-\u03baB pathway to enhance Slc26a3 expression and improve the intestinal epithelial barrier to relieve colitis","volume":"72","author":"Peng","year":"2024","journal-title":"J. Agric. Food Chem."},{"key":"ref_36","unstructured":"OCEBM Working Group (2025, August 08). The Oxford 2011 Levels of Evidence. Oxford Centre for Evidence-Based Medicine. 2011. Available online: https:\/\/www.cebm.ox.ac.uk\/resources\/levels-of-evidence."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: An emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref_38","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2024). Cochrane Handbook for Systematic. Reviews of Interventions, Version 6.5 (Updated August 2024), Cochrane. Available online: https:\/\/training.cochrane.org\/handbook."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1093\/ajcn\/82.4.777","article-title":"Geriatric nutritional risk index: A new index for evaluating at-risk elderly medical patients","volume":"82","author":"Bouillanne","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"427","DOI":"10.21873\/anticanres.16828","article-title":"Association of pre-operative geriatric nutritional risk index with complete adjuvant chemotherapy and prognosis post-pancreatectomy","volume":"44","author":"Higashi","year":"2024","journal-title":"Anticancer. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1007\/s00432-014-1714-3","article-title":"The prognostic significance of the prognostic nutritional index in cancer: A systematic review and meta-analysis","volume":"140","author":"Sun","year":"2014","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/j.ejso.2015.07.022","article-title":"Prognostic nutritional index predicts survival and correlates with systemic inflammatory response in advanced pancreatic cancer","volume":"41","author":"Geng","year":"2015","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/j.asjsur.2024.10.151","article-title":"Clinical impact of the prognostic nutritional index and skeletal muscle index for the incompletion of adjuvant chemotherapy for pancreatic cancer","volume":"48","author":"Maehira","year":"2025","journal-title":"Asian J. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Kawahara, S., Aoyama, T., Murakawa, M., Kanemoto, R., Takahashi, D., Kamioka, Y., Hashimoto, I., Maezawa, Y., Kobayashi, S., and Ueno, M. (2024). Prognostic nutritional index is an independent risk factor for continuing S-1 adjuvant chemotherapy in patients with pancreatic cancer who received neoadjuvant chemotherapy and surgical resection. BMC Cancer, 24.","DOI":"10.1186\/s12885-024-13244-z"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Hajibandeh, S., Hajibandeh, S., Romman, S., Parente, A., Laing, R.W., Satyadas, T., Subar, D., Aroori, S., Bhatt, A., and Durkin, D. (2023). Preoperative C-reactive protein-to-albumin ratio and its ability to predict outcomes of pancreatic cancer resection: A systematic review. Biomedicines, 11.","DOI":"10.3390\/biomedicines11071983"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Hang, J., Xue, P., Yang, H., Li, S., Chen, D., Zhu, L., Huang, W., Ren, S., Zhu, Y., and Wang, L. (2017). Pretreatment C-reactive protein to albumin ratio for predicting overall survival in advanced pancreatic cancer patients. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-03153-6"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1139\/H08-075","article-title":"A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care","volume":"33","author":"Mourtzakis","year":"2008","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12957-024-03310-y","article-title":"Association between preoperative sarcopenia and prognosis of pancreatic cancer after curative-intent surgery: An updated systematic review and meta-analysis","volume":"22","author":"Liu","year":"2024","journal-title":"World J. Surg. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"6126","DOI":"10.1097\/JS9.0000000000000989","article-title":"Preoperative low skeletal muscle mass index assessed using L3-CT as a prognostic marker of clinical outcomes in pancreatic cancer patients undergoing surgery: A systematic review and meta-analysis","volume":"110","author":"Raoul","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1159\/000524575","article-title":"Measurement of body composition in pancreatic cancer: A systematic review, meta-analysis, and recommendations for future study design","volume":"39","author":"Griffin","year":"2022","journal-title":"Dig. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.hpb.2019.05.018","article-title":"Body composition assessment and sarcopenia in patients with pancreatic cancer: A systematic review and meta-analysis","volume":"21","author":"Bundred","year":"2019","journal-title":"HPB"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"310","DOI":"10.5582\/bst.2023.01209","article-title":"Impact of sarcopenia on S1 adjuvant chemotherapy and prognosis in pancreatic cancer patients","volume":"17","author":"Takagi","year":"2023","journal-title":"Biosci. Trends"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.gassur.2023.12.022","article-title":"Body composition measurements and clinical outcomes in patients with resectable pancreatic adenocarcinoma: Analysis from SWOG S1505","volume":"28","author":"Sohal","year":"2024","journal-title":"J. Gastrointest. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Unno, M., Motoi, F., Matsuyama, Y., Satoi, S., Toyama, H., Matsumoto, I., Aosasa, S., Shirakawa, H., Wada, K., and Fujii, T. (2025). Neoadjuvant Chemotherapy with Gemcitabine and S-1 Versus Upfront Surgery for Resectable Pancreatic Cancer: Results of the Randomized Phase II\/III Prep-02\/JSAP05 Trial. Ann. Surg., Online ahead of print.","DOI":"10.1097\/SLA.0000000000006730"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"109026","DOI":"10.1016\/j.surg.2024.109026","article-title":"Neoadjuvant gemcitabine and S-1 in pancreatic ductal adenocarcinoma: Effects on nutritional status and pancreaticoduodenectomy outcomes","volume":"180","author":"Takamoto","year":"2025","journal-title":"Surgery"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1097\/SLA.0000000000001732","article-title":"Evidence-based guidelines for the management of exocrine pancreatic insufficiency after pancreatic surgery","volume":"264","author":"Sabater","year":"2016","journal-title":"Ann. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1053\/gast.2002.33587","article-title":"A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer","volume":"122","author":"Gianotti","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Vella, R., Pizzocaro, E., Bannone, E., Gualtieri, P., Frank, G., Giardino, A., Frigerio, I., Pastorelli, D., Gruttadauria, S., and Mazzali, G. (2024). Nutritional intervention for the elderly during chemotherapy: A systematic review. Cancers, 16.","DOI":"10.3390\/cancers16162809"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1080\/01635581.2020.1871495","article-title":"Randomized phase II study of gemcitabine monotherapy vs. gemcitabine with an EPA-enriched oral supplement in advanced pancreatic cancer","volume":"74","author":"Ueno","year":"2022","journal-title":"Nutr. Cancer"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Emanuel, A., Krampitz, J., Rosenberger, F., Kind, S., and R\u00f6tzer, I. (2022). Nutritional interventions in pancreatic cancer: A systematic review. Cancers, 14.","DOI":"10.3390\/cancers14092212"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Pires, L.B.C., Salaroli, L.B., Podesta, O.P.G., Haraguchi, F.K., and Lopes-J\u00fanior, L.C. (2024). Omega-3 supplementation and nutritional status in patients with pancreatic neoplasms: A systematic review. Nutrients, 16.","DOI":"10.3390\/nu16234036"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"885","DOI":"10.4240\/wjgs.v13.i9.885","article-title":"Neoadjuvant treatment: A window of opportunity for nutritional prehabilitation in patients with pancreatic ductal adenocarcinoma","volume":"13","author":"Trestini","year":"2021","journal-title":"World J. Gastrointest. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/SLA.0000000000005878","article-title":"Effects of a Pragmatic Home-Based Exercise Program Concurrent with Neoadjuvant Therapy on Physical Function of Patients with Pancreatic Cancer: The PancFit Randomized Clinical Trial","volume":"278","author":"Parker","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.cell.2014.08.007","article-title":"Vitamin D receptor-mediated stromal reprogramming suppresses pancreatitis and enhances pancreatic cancer therapy","volume":"159","author":"Sherman","year":"2014","journal-title":"Cell"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"807","DOI":"10.21037\/gs-2024-541","article-title":"Geriatric Nutritional Risk Index Predicts Postoperative Outcomes in Elderly Patients with Pancreatoduodenectomy: A Propensity Score-Matched Analysis","volume":"14","author":"Liu","year":"2025","journal-title":"Gland. Surg."},{"key":"ref_66","first-page":"240","article-title":"The Prognostic Impact of Preoperative Nutritional Status on Postoperative Complications and Overall Survival in Patients with Resectable Pancreatic Cancer","volume":"33","author":"Karahan","year":"2025","journal-title":"Support. Care Cancer"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Funamizu, N., Mori, S., Sakamoto, A., Honjo, M., Tamura, K., Sakamoto, K., Ogawa, K., Umeda, Y., Aoki, T., and Takada, Y. (2025). Novel Modified Frailty Index Predicts Completion of Adjuvant Chemotherapy in Resectable Pancreatic Cancer in a Dual Center Study. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-02365-5"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1002\/ags3.12897","article-title":"Combined Effect of Frailty and Sarcopenia on Postoperative Complications in Older Adults Undergoing Curative Surgery for Hepato-Biliary-Pancreatic Cancer","volume":"9","author":"Harimoto","year":"2024","journal-title":"Ann. Gastroenterol. Surg."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Funamizu, N., Omura, K., Takada, Y., Ozaki, T., Mishima, K., Igarashi, K., and Wakabayashi, G. (2020). Geriatric Nutritional Risk Index Less Than 92 Is a Predictor for Late Postpancreatectomy Hemorrhage Following Pancreatoduodenectomy: A Retrospective Cohort Study. Cancers, 12.","DOI":"10.3390\/cancers12102779"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Funamizu, N., Sogabe, K., Shine, M., Utsunomiya, T., Honjo, M., Ito, C., Uraoka, M., Nagaoka, T., Tamura, K., and Sakamoto, K. (2022). Association between the Preoperative C-Reactive Protein-to-Albumin Ratio and the Risk for Postoperative Pancreatic Fistula following Distal Pancreatectomy for Pancreatic Cancer. Nutrients, 14.","DOI":"10.3390\/nu14245277"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Mortier, V., Wei, F., Pellat, A., Marchese, U., Dohan, A., Brezault, C., Barat, M., Fuks, D., Soyer, P., and Coriat, R. (2022). Impact of Sarcopenia on Patients with Localized Pancreatic Ductal Adenocarcinoma Receiving FOLFIRINOX or Gemcitabine as Adjuvant Chemotherapy. Cancers, 14.","DOI":"10.3390\/cancers14246179"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S1470-2045(08)70153-0","article-title":"Prevalence and Clinical Implications of Sarcopenic Obesity in Patients with Solid Tumours of the Respiratory and Gastrointestinal Tracts","volume":"9","author":"Prado","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1200\/JCO.2012.45.2722","article-title":"Cancer Cachexia in the Age of Obesity: Skeletal Muscle Depletion Is a Powerful Prognostic Factor, Independent of Body Mass Index","volume":"31","author":"Martin","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"256","DOI":"10.21037\/hbsn.2015.12.08","article-title":"Preoperative Body Mass Index-to-Prognostic Nutritional Index Ratio Predicts Pancreatic Fistula after Pancreaticoduodenectomy","volume":"5","author":"Sato","year":"2016","journal-title":"Hepatobiliary Surg. Nutr."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Cintoni, M., Grassi, F., Palombaro, M., Rinninella, E., Pulcini, G., Di Donato, A., Salvatore, L., Quero, G., Tortora, G., and Alfieri, S. (2023). Nutritional interventions during chemotherapy for pancreatic cancer: A systematic review of prospective studies. Nutrients, 15.","DOI":"10.3390\/nu15030727"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Poulia, K.A., Antoniadou, D., Sarantis, P., and Karamouzis, M.V. (2022). Pancreatic Cancer Prognosis, Malnutrition Risk, and Quality of Life: A Cross-Sectional Study. Nutrients, 14.","DOI":"10.3390\/nu14030442"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1093\/jnci\/djr556","article-title":"Oral nutritional interventions in malnourished patients with cancer: A systematic review and meta-analysis","volume":"104","author":"Baldwin","year":"2012","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e793","DOI":"10.1093\/oncolo\/oyad101","article-title":"Pancreatic Enzyme Replacement and Nutritional Support with nab-Paclitaxel-Based First-Line Chemotherapy Regimens in Metastatic Pancreatic Cancer","volume":"28","author":"Giordano","year":"2023","journal-title":"Oncologist"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1038\/nrc3829","article-title":"Cancer cachexia: Understanding the molecular basis","volume":"14","author":"Busquets","year":"2014","journal-title":"Nat. Rev. Cancer"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"17105","DOI":"10.1038\/nrdp.2017.105","article-title":"Cancer-Associated Cachexia","volume":"4","author":"Baracos","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.cell.2019.07.008","article-title":"Tumor Microbiome Diversity and Composition Influence Pancreatic Cancer Outcomes","volume":"178","author":"Riquelme","year":"2019","journal-title":"Cell"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1158\/2159-8290.CD-17-1134","article-title":"The Pancreatic Cancer Microbiome Promotes Oncogenesis by Induction of Innate and Adaptive Immune Suppression","volume":"8","author":"Pushalkar","year":"2018","journal-title":"Cancer Discov."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1126\/science.aay9189","article-title":"The Human Tumor Microbiome Is Composed of Tumor Type-Specific Intracellular Bacteria","volume":"368","author":"Nejman","year":"2020","journal-title":"Science"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2815","DOI":"10.1002\/jcsm.13638","article-title":"Tocilizumab for Advanced Non-Small-Cell Lung Cancer With Concomitant Cachexia: An Observational Study","volume":"15","author":"Du","year":"2024","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Chen, P., Wang, D., Zhan, Z., Chen, L., and Chen, Y. (2024). Tocilizumab in Combination with Corticosteroids: Potential for Managing Cancer Cachexia with Systemic Hyperinflammation. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1477310"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1158\/1078-0432.CCR-24-2920","article-title":"Phase I trial of TTI-101, a first-in-class oral inhibitor of STAT3, in patients with advanced solid tumors","volume":"31","author":"Tsimberidou","year":"2025","journal-title":"Clin. Cancer Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.clnu.2017.06.017","article-title":"ESPEN expert group recommendations for action against cancer-related malnutrition","volume":"36","author":"Arends","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1038\/sj.bjc.6605578","article-title":"Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres","volume":"102","author":"Pressoir","year":"2010","journal-title":"Br. J. Cancer"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"9385","DOI":"10.1002\/cam4.3556","article-title":"Cachexia, dietetic consultation, and survival in patients with pancreatic and periampullary cancer: A multicenter cohort study","volume":"9","author":"Latenstein","year":"2020","journal-title":"Cancer Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1177\/0884533617722929","article-title":"Nutrition Implications for Long-Term Survivors of Pancreatic Cancer Surgery","volume":"32","author":"Petzel","year":"2017","journal-title":"Nutr. Clin. Pract."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1016\/j.clnu.2024.06.037","article-title":"Dose Optimization of Pancreatic Enzyme Replacement Therapy Is Essential to Mitigate Muscle Loss in Patients with Advanced Pancreatic Cancer and Exocrine Pancreatic Insufficiency","volume":"43","author":"Klassen","year":"2024","journal-title":"Clin. Nutr."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Di Martino, M., de la Hoz Rodriguez, \u00c1., Saibanti, A., Salvador Camarmo, G., Pagano, N., Mart\u00edn-P\u00e9rez, E., and Donadon, M. (2025). Pancreatic Exocrine Insufficiency after Pancreatic Resection: A Systematic Review. BMC Surg., 25.","DOI":"10.1186\/s12893-025-02787-y"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Rovesti, G., Valoriani, F., Rimini, M., Bardasi, C., Ballarin, R., Di Benedetto, F., Menozzi, R., Dominici, M., and Spallanzani, A. (2021). Clinical implications of malnutrition in the management of patients with pancreatic cancer: Introducing the concept of the nutritional oncology board. Nutrients, 13.","DOI":"10.3390\/nu13103522"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/j.cmet.2016.10.010","article-title":"Tumor-Induced IL-6 Reprograms Host Metabolism to Suppress Anti-Tumor Immunity","volume":"24","author":"Flint","year":"2016","journal-title":"Cell Metab."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"e2215095120","DOI":"10.1073\/pnas.2215095120","article-title":"A TGF-\u03b2\/KLF10 Signaling Axis Regulates Atrophy-Associated Genes to Induce Muscle Wasting in Pancreatic Cancer","volume":"120","author":"Dasgupta","year":"2023","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Vaes, R.D.W., van Bijnen, A.A., Olde Damink, S.W.M., and Rensen, S.S. (2024). Pancreatic Tumor Organoid-Derived Factors from Cachectic Patients Disrupt Contractile Smooth Muscle Cells. Cancers, 16.","DOI":"10.3390\/cancers16030542"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Meyer-Knees, J.W., Falkenthal, J., Geisel, D., Neumann, C.C.M., Hilfenhaus, G., Stephan, L.U., Sch\u00f6ning, W., Malinka, T., Pratschke, J., and Stintzing, S. (2024). Cachexia-Affected Survival Based on Inflammatory Parameters Compared to Complex Conventional Nutritional Assessments in Patients with Pancreatic Cancer and Other Gastrointestinal Tumors\u2014The CONKO 020 Investigation. Cancers, 16.","DOI":"10.3390\/cancers16061194"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Bossi, P., Delrio, P., Mascheroni, A., and Zanetti, M. (2021). The Spectrum of Malnutrition\/Cachexia\/Sarcopenia in Oncology According to Different Cancer Types and Settings: A Narrative Review. Nutrients, 13.","DOI":"10.3390\/nu13061980"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"2981","DOI":"10.1002\/jcsm.13420","article-title":"Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: Update 2023","volume":"14","author":"Coats","year":"2023","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_100","first-page":"7960","article-title":"Therapeutic Strategies Against Cancer Cachexia","volume":"29","author":"Stemmler","year":"2019","journal-title":"Eur. J. Transl. Myol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"112697","DOI":"10.1016\/j.nut.2025.112697","article-title":"Research progress on the mechanism and treatment of cachexia based on tumor microenvironment","volume":"133","author":"Zhao","year":"2025","journal-title":"Nutrition"},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Funamizu, N., Honjo, M., Tamura, K., Sakamoto, K., Ogawa, K., and Takada, Y. (2023). microRNAs Associated with Gemcitabine Resistance via EMT, TME, and Drug Metabolism in Pancreatic Cancer. Cancers, 15.","DOI":"10.3390\/cancers15041230"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1002\/ijc.27736","article-title":"Macrophage migration inhibitory factor induces epithelial to mesenchymal transition, enhances tumor aggressiveness and predicts clinical outcome in resected pancreatic ductal adenocarcinoma","volume":"132","author":"Funamizu","year":"2013","journal-title":"Int. J. Cancer"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"725","DOI":"10.3892\/ijo.2014.2243","article-title":"MicroRNA-301b promotes cell invasiveness through targeting TP63 in pancreatic carcinoma cells","volume":"44","author":"Funamizu","year":"2014","journal-title":"Int. J. Oncol."},{"key":"ref_105","first-page":"991","article-title":"MicroRNA-200b and -301 are associated with gemcitabine response as biomarkers in pancreatic carcinoma cells","volume":"54","author":"Funamizu","year":"2019","journal-title":"Int. J. Oncol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/1476-4598-9-169","article-title":"MicroRNA, hsa-miR-200c, Is an Independent Prognostic Factor in Pancreatic Cancer and Its Upregulation Inhibits Pancreatic Cancer Invasion but Increases Cell Proliferation","volume":"9","author":"Yu","year":"2010","journal-title":"Mol. Cancer"},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"LaConti, J.J., Shivapurkar, N., Preet, A., Deslattes Mays, A., Peran, I., Kim, S.E., Marshall, J.L., Riegel, A.T., and Wellstein, A. (2011). Tissue and serum microRNAs in the Kras(G12D) transgenic animal model and in patients with pancreatic cancer. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0020687"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1126\/science.aan4236","article-title":"Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients","volume":"359","author":"Gopalakrishnan","year":"2018","journal-title":"Science"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1038\/nrgastro.2017.20","article-title":"Gut microbiota modulation of chemotherapy efficacy and toxicity","volume":"14","author":"Alexander","year":"2017","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1038\/nrmicro.2017.44","article-title":"Anticancer effects of the microbiome and its products","volume":"15","author":"Zitvogel","year":"2017","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1080\/17474124.2024.2412045","article-title":"Metabolites Derived from Gut Microbiota Mitigate Chemoresistance in Pancreatic Cancer","volume":"18","author":"Deng","year":"2024","journal-title":"Expert. Rev. Gastroenterol. Hepatol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1126\/science.aah5043","article-title":"Potential Role of Intratumor Bacteria in Mediating Tumor Resistance to Gemcitabine Chemotherapy","volume":"357","author":"Geller","year":"2017","journal-title":"Science"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/9\/519\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:46:56Z","timestamp":1760035616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/9\/519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":112,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["curroncol32090519"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32090519","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]}}}