Association of dietary intake patterns with treatment outcomes in late-stage pancreatic tumors

Background: Dietary intake patterns are increasingly recognized as potential factors associated with treatment response and survival in patients with advanced pancreatic cancer; however, evidence from real-world clinical settings remains limited. Methods: This retrospective observational study analyzed electronic medical record data from 210 patients with Stage III-IV pancreatic adenocarcinoma. Dietary patterns were categorized as High-Fat Western, Mixed/Transitional, or Plant-Rich based on standardized nutritional assessments. Clinical characteristics, treatment regimens, nutrient intake, chemotherapy response, progression-free survival (PFS), overall survival (OS), and adverse events were observed. Multivariate logistic regression and Cox proportional hazards models were used to examine the independent association between dietary factors and treatment outcomes. Results: < 0.01). The High-Fat Western group had the highest intake of saturated fat, cholesterol, and processed meats, along with the lowest intake of fiber and micronutrients. The dietary pattern was associated with lower rates of complete/partial response (15.8%), shorter OS (6.4 ± 2.1 months), and shorter PFS (3.2 ± 1.5 months). In contrast, the plant-rich pattern was associated with the most favorable nutrient intake and longer survival outcome (OS 10.5 ± 3.2 months; PFS 5.3 ± 2.0 months). Multivariable analyses demonstrated that adherence to High-Fat Western diets was associated with increased odds of progressive disease (OR = 2.96; 95% CI: 1.59-5.48) and higher hazards of death or progression (HR = 2.42; 95% CI: 1.57-3.74). Low fiber intake, low omega-3, high saturated fat, and lower vitamin C were independently associated with poor outcomes. Additionally, clinical complications, such as severe fatigue, cachexia progression, dose reductions, and treatment discontinuation, were significantly associated with reduced survival. Conclusion: In patients with advanced pancreatic cancer, diet quality was significantly associated with treatment response and survival outcomes. Plant-rich dietary patterns were associated with more favorable clinical outcomes, whereas high-fat, processed-food dietary patterns were associated with poorer response rates and shorter survival. These findings highlight a clinically meaningful association between nutritional status and oncologic outcomes and support the consideration of routine nutritional assessment.