[From malnutrition to surgery: the role of supportive parenteral nutrition]

Patients with pancreatic cancer frequently present with protein-energy malnutrition, which can negatively affect prognosis and treatment tolerance. We report the clinical case of a 55-year-old man with locally advanced pancreatic adenocarcinoma, deemed unresectable at diagnosis, who experienced severe weight loss (-23 kg in the last 4 months) and marked clinical deterioration. The prescription of supportive parenteral nutrition (PN) allowed stabilization of body weight, improvement of fatigue, and the resumption of chemotherapy cycles that had previously been interrupted due to worsening clinical conditions. After eight cycles of chemotherapy, restaging imaging revealed tumour regression, making a surgical reassessment possible. This case highlights the importance of early nutritional screening and targeted nutritional intervention in oncology patients, in order to optimize ongoing treatment response and broaden therapeutic opportunities.