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Updated: Sep 17, 2025
DIPLOMA Approach for Standardized Pathology Assessment of Distal Pancreatectomy Specimens
Published on: February 1, 2020
The preoperative cachexia index predicts outcomes after pancreatic resection for resectable pancreatic cancer
Ryoga Hamura1,2, Yoshihiro Shirai3, Masashi Tsunematsu3,4
1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan. rhamura@jikei.ac.jp.
Purpose:
The cachexia index (CXI) is a numerical measure of cachexia, calculated based on the skeletal muscle area and blood test values. However, the relationship between the preoperative CXI levels and pancreatic cancer prognosis has not been investigated.
Methods:
This retrospective study included 310 patients who underwent resection of resectable pancreatic cancer. We investigated the impact of CXI-low levels on the disease-free survival (DFS) and overall survival (OS) of patients following pancreatic resection for resectable pancreatic cancer.
Results:
There were 121 (42%) and 167 (58%) patients enrolled in the CXI-low and CXI-high groups, respectively. Multivariate analyses of the prognostic factors identified that CXI-low was an independent predictor of both DFS (hazard ratio [HR] 2.08, p < 0.01) and OS (HR 2.33, p < 0.01). In the CXI-low group, the time to recurrence was shorter (p < 0.01) and the initial treatment at recurrence was more difficult to initiate (p = 0.03). Similarly, for patients with neoadjuvant chemotherapy, CXI-low was an independent predictor of DFS (HR 3.73, p < 0.01) and OS (HR 16.9, p < 0.01).
Conclusion:
Preoperative CXI-low can be a significant prognostic factor for poor DFS and OS of patients with resectable pancreatic cancer. These results suggest that preoperative cancer cachexia influences the intensity of postoperative treatment.
