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Prognostic significance of skeletal muscle decrease in unresectable pancreatic cancer: Survival analysis using the

Hiroki Sato1, Takuma Goto1, Akihiro Hayashi1

  • 1Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-Higashi, Asahikawa, Japan.

Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [Et Al.]
|March 16, 2021
PubMed
Summary

Low skeletal muscle mass is a key predictor of poor survival in pancreatic ductal adenocarcinoma (PDA) patients undergoing chemotherapy. This finding aids in predicting patient outcomes and developing targeted therapies.

Keywords:
Mathematical modelingPancreatic cancerSarcopeniaSkeletal muscle indexSurvival analysis

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Area of Science:

  • Oncology
  • Medical Imaging
  • Biostatistics

Background:

  • Pancreatic ductal adenocarcinoma (PDA) is linked to decreased skeletal muscle mass, impacting patient prognosis.
  • Skeletal muscle mass and function are critical indicators of patient outcomes after PDA treatment.

Purpose of the Study:

  • To investigate the association between skeletal muscle mass decrease and outcomes in patients with advanced pancreatic ductal adenocarcinoma undergoing chemotherapy.
  • To evaluate predictive models for patient survival in advanced PDA.

Main Methods:

  • Retrospective analysis of 112 advanced PDA patients receiving chemotherapy.
  • Collected data included patient demographics, hematological markers, inflammation, nutritional biomarkers, and imaging parameters for skeletal muscle and adipose tissue.
  • Compared the predictive efficiency of Cox, Weibull, and standardized exponential models using hazard ratios and Akaike Information Criterion (AIC).

Main Results:

  • Low skeletal muscle mass, poor performance status (PS), and biliary drainage were strongly associated with increased mortality risk.
  • Carcinoembryonic antigen (CEA) levels and ascites presence also correlated with higher mortality.
  • The Weibull-exponential model demonstrated the lowest AIC, indicating superior performance for survival prediction.

Conclusions:

  • Skeletal muscle index, PS, biliary drainage, CEA levels, and ascites are independent predictors of poor survival in advanced PDA patients post-chemotherapy.
  • Parametric survival modeling, specifically using the Weibull-exponential distribution, offers improved accuracy for predicting outcomes in advanced PDA.