Body composition parameters predict survival in pancreatic cancer—A retrospective multicenter analysis

Author:

Damm Marko1ORCID,Efremov Ljupcho23,Jalal Mustafa4,Nadeem Nabeegh4,Dober Johannes5,Michl Patrick16,Wohlgemuth Walter A.5,Wadsley Jonathan7,Hopper Andrew D.8,Krug Sebastian16,Rosendahl Jonas1

Affiliation:

1. Department of Internal Medicine I University Hospital Halle Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany

2. Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI) Interdisciplinary Center for Health Sciences Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany

3. Department of Radiation Oncology Martin‐Luther‐University Halle (Saale) Germany

4. Academic Department of Gastroenterology Royal Hallamshire Hospital Sheffield UK

5. Department of Radiology University Hospital Halle Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany

6. Department of Internal Medicine IV University Hospital Heidelberg Heidelberg Germany

7. Department of Oncology Weston Park Hospital Sheffield UK

8. Department of Infection and Immunity and Cardiovascular Disease University of Sheffield Sheffield UK

Abstract

AbstractBackgroundParameters to adapt individual treatment strategies for patients with pancreatic ductal adenocarcinoma (PDAC) are urgently needed. The present study aimed to evaluate body composition parameters as predictors of overall survival (OS) in PDAC patients.MethodsMeasurements of body composition parameters were performed on computed tomography scans at diagnosis. Height‐standardized and Body Mass Index‐ and sex‐adjusted regression formulas deriving cut‐offs from a healthy population were used. The Kaplan‐Meier method with the log‐rank test was performed for survival analysis. Independent prognostic factors were identified with uni‐ and multivariable Cox regression analyses.ResultsIn total, 354 patients were analyzed. In a multivariable Cox model, besides tumor stage and resection status, only myosteatosis (HR 1.53; 95% CI 1.10–2.14, p = 0.01) was an independent prognostic factor of OS among body composition parameters. Subgroup analyses revealed that the prognostic impact of myosteatosis was higher in patients ≤68 years of age, with advanced tumor stages and patients without curative intended resection.ConclusionsThe analysis of one of the largest Caucasian cohorts to date, demonstrated myosteatosis to be an independent prognostic factor of OS in PDAC. To improve outcomes, prospective trials aiming to investigate the utility of an early assessment of myosteatosis with subsequent intervention by dieticians, sports medicine physicians, and physiotherapists are warranted.

Publisher

Wiley

Subject

Gastroenterology,Oncology

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