Sarcopenia is a reliable prognostic factor in patients with advanced pancreatic cancer receiving FOLFIRINOX chemotherapy

Kurita, Yusuke; Kobayashi, Noritoshi; Tokuhisa, Motohiko; Goto, Ayumu; Kubota, Kensuke; Endo, Itaru; Nakajima, Atsushi; Ichikawa, Yasushi

doi:10.1016/j.pan.2018.11.001

Cited by 70 publications

(69 citation statements)

References 34 publications

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“…On the other hand, as already described in other reports,[ 11 12 13 14 ] sarcopenia does not seem to correlate with increased rates of complications after the treatment, and our data support the excellent safety profile of EUS-CPN as no severe treatment-related AEs nor deaths were observed throughout the follow-up.…”

Section: Discussionsupporting

confidence: 90%

“…As already observed in other series,[ 11 12 13 14 ] sarcopenia also showed an impact on OS, which resulted significantly prolonged in nonsarcopenic patients (7 months as compared to 4; P = 0.05).…”

Section: Discussionsupporting

confidence: 83%

“…Although the prognostic role of sarcopenia in PC has already been described,[ 11 12 13 14 ] to the best of our knowledge, this is the first report on the correlation between sarcopenia and treatment outcomes of palliative therapy, such as EUS-guided CPN.…”

Section: Discussionmentioning

confidence: 96%

“…Recently, body composition was evaluated in different oncologic patient cohorts, hereby, sarcopenia proved as a prognostic factor of morbidity, mortality, and survival in several malignancies. [ 10 ] In PC, sarcopenia was found to correlate with poorer outcomes both in resectable and in advanced stage,[ 11 12 13 14 ] mainly due to impaired wound healing, depressed immunity, and the imbalance in several proinflammatory cytokines such as interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α). [ 15 ]…”

Section: Introductionmentioning

confidence: 99%

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Sarcopenia represents a negative prognostic factor in pancreatic cancer patients undergoing EUS celiac plexus neurolysis

2020

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Background and Objectives: Increasing evidence suggests a prognostic role of sarcopenia in pancreatic cancer patients. The aim of this study was to assess the influence of sarcopenia on treatment outcomes after EUS-guided celiac plexus neurolysis (CPN). Materials and Methods: Data regarding 215 patients treated with EUS CPN between 2004 and 2019 were reviewed. Determination of body composition was conducted on contrast-enhanced CT scan, and pain response was considered as the primary outcome. Univariate and multivariate logistic regression was performed to identify the independent predictors of pain response. Results: Treatment was successful in 187 patients (86.9%). The median age was 62 (range 39–84) years, and most patients were male (61.8%). Of the whole study population, 139 patients (64.6%) were defined as sarcopenic, of which 116 (83.4%) responded to the treatment and 5 (3.5%) experienced a complete response. Among 76 nonsarcopenic participants, 71 (93.4%) responded to the treatment and 22 (28.9%) obtained a complete response ( P = 0.03 and <0.001, respectively). The median duration of pain relief was 8 (2–10) and 15 (8–16) weeks in sarcopenic and nonsarcopenic patients, respectively ( P = 0.01). The median overall survival after neurolysis was 4 months (3–5) in sarcopenic participants and 7 months (6–8) in nonsarcopenic participants ( P = 0.05). Tumoral stage, interval from the diagnosis to treatment, and sarcopenia resulted as significant prognostic factors for treatment response both in univariate and multivariate regression analyses. No severe treatment-related adverse events were reported in the whole study population, with no difference between the two groups. Conclusions: Sarcopenia represents a predictor of poorer response to EUS CPN.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Sarcopenia represents a negative prognostic factor in pancreatic cancer patients undergoing EUS celiac plexus neurolysis

2020

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“…Preoperative sarcopenia is closely associated with both preoperative cancer stage and poor prognosis in pancreatic cancer [ 18 – 20 ]. Sarcopenia is a prognostic factor in patients with advanced pancreatic cancer because it impairs the response to chemotherapy [ 21 , 22 ]. However, the impact of sarcopenia for prognosis after recurrence in patients who underwent pancreatectomies for pancreatic cancer remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia as a prognostic factor in patients with recurrent pancreatic cancer: a retrospective study

et al. 2020

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Background: Sarcopenia is a prognostic factor in various cancers. However, the impact of sarcopenia in patients with recurrent pancreatic cancer remains unclear. This study evaluated the prognostic significance of sarcopenia in patients with recurrent pancreatic cancer. Methods: Seventy-four patients who developed postoperative recurrence of pancreatic cancer after undergoing pancreatectomies were enrolled. Sarcopenia in these patients was defined according to the psoas muscle index (PMI) measured via computed tomography at the third vertebra. Results: The mean PMIs at the time of recurrence were 4.47 ± 1.27 cm 2 /m 2 for men and 3.26 ± 0.70 cm 2 /m 2 for women. Of the 74 patients, 65 (87.8%) were diagnosed with sarcopenia with low PMI. The 2-year post-recurrence survival curve in the sarcopenia group was significantly worse than that in the non-sarcopenia group (P = 0.034). Multivariate analysis revealed that sarcopenia at the time of recurrence was an independent prognostic factor (P = 0.043) along with a high neutrophil-to-lymphocyte ratio (P = 0.004), early recurrence (P = 0.001), and chemotherapy after recurrence (P = 0.005) in patients with recurrent pancreatic cancer. Furthermore, the area under the curve (AUC) of the combination of sarcopenia and time to recurrence for predicting 2-year survival was 0.763, which was much higher than that of sarcopenia alone (AUC = 0.622). Conclusions: Sarcopenia is a useful prognostic factor in patients with recurrent pancreatic cancer. The combination of sarcopenia and time of recurrence may more accurately predict post-recurrence survival than can sarcopenia alone.

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Single-center risk factor analysis for FOLFIRINOX associated febrile neutropenia in patients with pancreatic cancer

Keum

Lee

Kang

et al. 2020

Cancer Chemother Pharmacol

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Sarcopenia is a reliable prognostic factor in patients with advanced pancreatic cancer receiving FOLFIRINOX chemotherapy

Cited by 70 publications

References 34 publications

Sarcopenia represents a negative prognostic factor in pancreatic cancer patients undergoing EUS celiac plexus neurolysis

Sarcopenia represents a negative prognostic factor in pancreatic cancer patients undergoing EUS celiac plexus neurolysis

Sarcopenia as a prognostic factor in patients with recurrent pancreatic cancer: a retrospective study

Single-center risk factor analysis for FOLFIRINOX associated febrile neutropenia in patients with pancreatic cancer

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