Related Experiment Video
Updated: Aug 8, 2026
DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens
Published on: February 1, 2020
Prognostic Significance of GLIM-Defined Malnutrition in Patients With Resectable Pancreatic Adenocarcinoma Following
Takuya Mizumoto1, Yoshihide Nanno1, Jun Ishida1
1Division of Hepato-Biliary-Pancreatic Surgery Department of Surgery Kobe University Graduate School of Medicine Kobe Hyogo Japan.
Aim:
Regarding the resectability of pancreatic adenocarcinoma (PDAC), not only anatomical factors but also biological and conditional factors have come to be considered. This study examined the impact of the Global Leadership Initiative on Malnutrition (GLIM) criteria on prognosis after resection of anatomically resectable PDAC.
Methods:
The medical records of consecutive patients who underwent resection for resectable PDAC between January 1, 2014, and December 31, 2022, were retrospectively reviewed. Patients were classified as normal, moderately, or severely malnourished according to the GLIM criteria.
Results:
In total, 194 patients were included in the analysis. According to the GLIM criteria, 61 (31.4%), 49 (25.2%), and 84 (42.3%) patients were normal, moderately, and severely malnourished, respectively. Patients with malnutrition had shorter overall, recurrence-free, and disease-specific survival (OS, RFS, and DSS) than normal patients (OS, normal vs. moderate, p = 0.015; normal vs. severe, p < 0.001; RFS, normal vs. moderate p = 0.012, normal vs. severe, p < 0.001; DSS, normal vs. moderate, p = 0.023; normal vs. severe, p < 0.001). In multivariate analysis regarding OS using all factors, moderate or severe malnutrition according to the GLIM criteria (p = 0.007), performance status (p = 0.086), preoperative diabetes (p = 0.017), tumor diameter ≥ 3 cm (p = 0.002), lymph node metastasis (p < 0.001), and postoperative adjuvant therapy (p = 0.027) were independent prognostic factors. In multivariate analysis using preoperative factors, malnutrition according to the GLIM criteria remained a significant prognostic factor (p = 0.003).
Conclusion:
The GLIM criteria are effective prognostic predictors in patients with resectable PDAC undergoing upfront surgery. Preoperative nutritional assessment using these criteria may contribute to determining treatment plans for resectable PDAC.
