Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Nutrition Impact Symptoms and Nutrition Outcomes in Patients with Pancreatic and Hepatobiliary Cancers During and After Treatment: A Systematic Review and Meta-Analysis. (145235)

Kate Connell 1 , Brooke Nuttall 1 , Kristin Solheim Hustad 2 , Diana Cardenas 2 3 , Marie Guinhut 3 , Erin Laing 4 5 6 , Amy Mcluskie 7 , Asta Bye 2 8 , Lisa Heide Koteng 2 , Amaia Urrizola 2 , Barry J A Laird 2 7 , Lauren Hanna 9 , Stein Kaasa 2 , Kate Furness 1
  1. Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Bundoora, Victoria, Australia
  2. European Palliative Care Research Centre (PRC), Department of Oncology, Institute of Clinical Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway
  3. Nutrition Unit, Gustave Roussy, Villejuif, Île-de-France, France
  4. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  5. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
  6. School of Nutrition and Exercise, Deakin University, Burwood, Victoria, Australia
  7. Edinburgh Cancer Research Centre, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, Scotland, United Kingdom
  8. Department of Nursing and Health Promotion, OsloMet – Oslo Metropolitan University, Oslo, Norway
  9. Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia

Aims: Pancreatic and hepatobiliary cancers are associated with a high burden of nutrition-impact symptoms, which contribute to adverse nutritional outcomes (1-3). However, their prevalence, severity and nutritional consequences remain poorly characterised (4). This review examined the prevalence and severity of nutrition-impact symptoms during and after standard treatment (surgery, chemotherapy and/or radiotherapy) for pancreatic and hepatobiliary cancer and their associations with nutritional outcomes, to inform supportive care strategies and identify research priorities.

Methods: Four electronic databases were systematically searched for studies of adults with pancreatic and hepatobiliary cancer receiving standard therapy that assessed nutrition-impact symptoms and nutritional outcomes at two or more timepoints using validated tools. Study quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Results were synthesised narratively, and meta-analysis was performed where appropriate.

Results:  Twelve studies (n = 744) were included, comprising 11 pancreatic and one mixed pancreatic/hepatobiliary study. The median study size was 49 participants (IQR 29–83.5; range 3–150). Most studies evaluated chemotherapy (n=9), and fewer evaluated surgery (n=4). Fatigue, pain, anorexia, diarrhoea and nausea were commonly reported. Most clinician-graded events were mild to moderate. Patient-reported outcomes indicated greater symptom burden. Meta-analysis showed that 47% of patients experienced clinician-graded fatigue during and immediately after treatment (95% CI 23-72%; I² = 92%; n = 235). A significant reduction in body weight from pre-treatment to three months was observed (mean difference -4.62 kg, 95% CI -6.93 to −2.30; I²=59%; n = 186). Across studies, nutrition-impact symptoms generally increased during systemic therapy and were consistently associated with adverse nutritional outcomes.

Conclusion: Nutrition-impact symptoms are common in pancreatic and hepatobiliary cancer and are associated with adverse nutritional outcomes. These findings support routine integration of nutrition assessment and intervention throughout pancreatic and hepatobiliary cancer care and highlight the need for prospective longitudinal studies evaluating nutrition-impact symptom management strategies.

  1. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48.
  2. Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018;4:17105.
  3. Prado CM, Purcell SA, Alish C, Pereira SL, Deutz NE, Heyland DK, et al. Implications of low muscle mass across the continuum of care: a narrative review. Ann Med. 2018;50(8):675-93.
  4. McShane E, Hanna L, Zoanetti C, Murnane L, Baguley B, Furness K. The Effect of Nutrition Impact Symptoms on Nutrition Status After Completion of Curative-Intent Treatment for Gastric, Oesophageal, and Pancreatic Cancer: A Systematic Review. Nutrients. 2025;17(16).