Neoadjuvant Treatment is a Risk Factor for Clinically Relevant Chyle Leak (ISGPS Grade B/C) After Pancreatic Cancer...

Area of Science:

• Surgical Oncology
• Gastroenterology
• Clinical Research

Background:

• Chyle leak is a significant complication following pancreatic ductal adenocarcinoma (PDAC) surgery.
• The rise of neoadjuvant therapy (NAT) and extensive resections may increase chyle leak incidence.
• Understanding risk factors is crucial for managing PDAC patients.

Purpose of the Study:

• To determine the incidence of clinically relevant chyle leak in PDAC patients.
• To identify risk factors for chyle leak in patients treated with NAT and surgery versus upfront surgery.

Main Methods:

• Analysis of a prospective institutional database of 1402 PDAC resections (2014-2019).
• Inclusion of clinicopathologic and demographic data.
• Logistic regression to identify factors associated with clinically relevant chyle leak (ISGPS criteria).

Main Results:

• Overall, 7.7% of patients developed clinically relevant chyle leak (Grade B/C).
• Neoadjuvant therapy (NAT) was an independent risk factor for any chyle leak (OR 1.45) and Grade B/C leak (OR 2.63).
• Advanced T stage and total pancreatectomy were associated with any chyle leak, but not specifically Grade B/C leaks.

Conclusions:

• Neoadjuvant therapy (NAT) is a significant independent risk factor for clinically relevant chyle leaks after PDAC resection.
• Findings suggest a need for risk-adapted postoperative management strategies.
• Prospective validation of these findings is warranted.