Background : Currently, neoadjuvant treatment is increasing in the treatment of pancreatic cancer. In the case of patients who received neoadjuvant treatment, the nutritional risk is predicted, but there is no study related to the nutrition index. This study aims to investigate the differences in nutrition and inflammation markers of patients who received neoadjuvant treatment compared to those of pancreatic cancer patients who underwent upfront surgery.

Methods : This study enrolled 66 patients who underwent pancreatectomy due to resectable and borderline resectable pancreatic cancer from 2020 to 2021. Clinical data were retrospectively collected, and comparative analyzes were performed for preoperative nutrition index and inflammation markers and clinical outcomes.( NLR; Neutrophil to lymphocyte ratio, LMR; Lymphocyte-monocyte ratio, SIRI; Systemic inflammation response index,AISI; Aggregate Index of Systemic Inflammation)

Results : 35 patients underwent upfront surgery and 31 patients underwent neoadjuvant treatment. In perioperative outcome, neoadjuvant treatment group showed more blood loss than upfront surgery group.( 1147.67±774.49 and 783.71±519.73, p = 0.034) In postoperative outcome, there was no significant difference of complication rate. In terms of nutrition index and inflammatory markers, preoperative NLR(2.25±1.24 and 2.12±0.94), SIRI(1.3419±0.94 and 1.0549±0.56), and AISI (329.597±310.96 and 245.566±155.99) were high in the neoadjuvant treatment group and preoperative LMR value(3.552±1.39 and 3.871±1.79) were low in the neoadjuvant treatment group.

Conclusions : In this study, preoperative nutrition index and inflammatory markers associated with poor prognosis and severe inflammation. Therefore, preoperative rehabilitation and nutritional support will be required in neoadjuvant treatment patients for pancreatic cancer.