The impact of sarcopenia and decrease in skeletal muscle mass in patients with advanced pancreatic cancer during FOLFIRINOX therapy

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Shinya Uemura ◽  
Takuji Iwashita ◽  
Hironao Ichikawa ◽  
Yuhei Iwasa ◽  
Naoki Mita ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Tumour Size ◽  
Advanced Pancreatic Cancer ◽  
Significant Risk ◽  
Skeletal Muscle Index ◽  
Significant Difference ◽  
The Impact

Abstract Sarcopenia, defined as decrease in skeletal muscle mass (SMM) and strength, might be associated with reduced survival. We investigated the impact of sarcopenia and decrease in SMM in patients with advanced pancreatic cancer during FOLFIRINOX (FX) therapy. Consecutive sixty-nine patients who received FX were evaluated. Skeletal muscle index (SMI) (cm2/m2) was used to evaluate SMM. The cut-off value of sarcopenia was defined as SMI <42 for males and <38 for females, based on the Asian Working Group for sarcopenia criteria. Sarcopenia was diagnosed in thirty-three (48 %) subjects. Comparison of baseline characteristics of the two groups (sarcopenia group: non-sarcopenia group) showed a significant difference in sex, tumour size and BMI. There was no significant difference in the incidence of adverse events with grades 3–5 and progression-free survival (PFS) during FX between the two groups (PFS 8·1 and 8·8 months; P = 0·88). On the multivariate analysis, progressive disease at the first follow-up computed tomography (hazard ratio (HR) 3·87, 95 % CI 1·53, 9·67), decreased SMI ≥ 7·9 % in 2 months (HR 4·02, 95 % CI 1·87, 8·97) and carcinoembryonic antigen ≥ 4·6 (HR 2·52, 95 % CI 1·10, 6·11) were significant risk factors associated with poor overall survival (OS), but sarcopenia at diagnosis was not. OS in patients with decreased SMI of ≥7·9 % and <7·9 % were 10·9 and 21·0 months (P < 0·01), respectively. In conclusion, decrease in SMM within 2 months after the initiation of chemotherapy had significantly shorter OS, although sarcopenia at diagnosis did not affect OS. Therefore, it might be important to maintain SMM during chemotherapy for a better prognosis.

scholarly journals The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients

2019 ◽  
Vol 10 (2) ◽  
pp. 368-377 ◽  
Author(s):  
Debora Basile ◽  
Annamaria Parnofiello ◽  
Maria Grazia Vitale ◽  
Francesco Cortiula ◽  
Lorenzo Gerratana ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Advanced Pancreatic Cancer ◽  
Impact Study ◽  
Early Loss ◽  
The Impact

Mo1358 THE IMPACT OF SKELETAL MUSCLE MASS LOSS IN PATIENTS WITH ADVANCED PANCREATIC CANCER DURING FOLFIRINOX

2020 ◽  
Vol 158 (6) ◽  
pp. S-863
Author(s):  
Shinya Uemura ◽  
Takuji Iwashita ◽  
Hironao Ichikawa ◽  
Yuhei Iwasa ◽  
Naoki Mita ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Mass Loss ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Advanced Pancreatic Cancer ◽  
Muscle Mass Loss ◽  
The Impact

Skeletal Muscle Mass Predicts Poor Prognosis in Patients with Advanced Pancreatic Cancer Undergoing Second-Line FOLFIRINOX Chemotherapy

2019 ◽  
Vol 71 (7) ◽  
pp. 1100-1107 ◽  
Author(s):  
Hee Seung Lee ◽  
Si Young Kim ◽  
Moon Jae Chung ◽  
Jeong Youp Park ◽  
Seungmin Bang ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Muscle Mass ◽  
Poor Prognosis ◽  
Skeletal Muscle Mass ◽  
Advanced Pancreatic Cancer ◽  
Second Line

scholarly journals Continued Weight Loss and Sarcopenia Predict Poor Outcomes in Locally Advanced Pancreatic Cancer Treated with Chemoradiation

Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 709 ◽  
Author(s):  
Patrick Naumann ◽  
Jonathan Eberlein ◽  
Benjamin Farnia ◽  
Thilo Hackert ◽  
Jürgen Debus ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Weight Loss ◽  
Muscle Mass ◽  
Muscle Wasting ◽  
Statistical Tests ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Skeletal Muscle Index ◽  
Poor Outcomes

Background: Surgical resection offers the best chance of survival in patients with pancreatic cancer, but those with locally advanced disease (LAPC) are usually not surgical candidates. This cohort often receives either neoadjuvant chemotherapy or chemoradiation (CRT), but unintended weight loss coupled with muscle wasting (sarcopenia) can often be observed. Here, we report on the predictive value of changes in weight and muscle mass in 147 consecutive patients with LAPC treated with neoadjuvant CRT. Methods: Clinicopathologic data were obtained via a retrospective chart review. The abdominal skeletal muscle area (SMA) at the third lumbar vertebral body was determined via computer tomographic (CT) scans as a surrogate for the muscle mass and skeletal muscle index (SMI) calculated. Uni- and multi-variable statistical tests were performed to assess for impact on survival. Results: Weight loss (14.5 vs. 20.3 months; p = 0.04) and loss of muscle mass (15.1 vs. 22.2 months; p = 0.007) were associated with poor outcomes. The highest survival was observed in patients who had neither cachectic weight loss nor sarcopenia (27 months), with improved survival seen in those who ultimately received a resection (23 vs. 10 months; p < 0.001). Cox regression revealed that either continued weight loss or continued muscle wasting (SMA reduction) was predictive of poor outcomes, whereas a sarcopenic SMI was not. Conclusions: Loss of weight and lean muscle in patients with LAPC is prognostic when persistent. Therefore, both should be assessed longitudinally and considered before surgery.

scholarly journals Impact of Low Skeletal Muscle Mass on Complications and Survival for Gastric Cancer: A Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Zhen Fang ◽  
Peijuan Li ◽  
Jin Liu ◽  
Wei Chong ◽  
Fengying Du ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Postoperative Complications ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Muscle Mass ◽  
Laparoscopic Gastrectomy ◽  
Skeletal Muscle Mass ◽  
Significant Difference ◽  
The Impact

Abstract Background: Increasing evidence has indicated that low skeletal muscle mass is linked with cancer prognosis, but existing have shown contrasting results. The purpose of the study is to determine the impact of preoperative low skeletal muscle mass (LSMM) on complications and survival of patients who undergo laparoscopic gastrectomy for gastric cancer (GC).Methods: Patients who undergo laparoscopic gastrectomy for GC were enrolled and third lumbar vertebra psoas muscles index (PMI) was assessed by computer tomography (CT). Using propensity score matching (1:1) to obtain 2 well-balanced cohorts for available variables influencing clinical outcomes, comparing the postoperative complications and 3-year overall survival (OS) between LSMM group and non-LSMM group.Results: A total of 386 patients, 226 were matched for analyses. Compared with the non-LSMM group, the LSMM group manifested significantly shorter 3-year OS (58.14% vs 71.95%, P=0.034). However, the incidence of postoperative complications was no difference between two groups after matching. After stratification based on the pT stage of the tumor, statistically significant difference in the 3-year OS rates of the advance GC cohort between the two groups were observed.Conclusions: LSMM predicts a poor prognosis for patients with advance GC and it is not associated with postoperative complications.

PS02.236: THE IMPACT OF PREOPERATIVE SKELETAL MUSCLE MASS ON POSTOPERATIVE OUTCOMES AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 189-189
Author(s):  
Shion Uemura ◽  
Toshiaki Shichinohe ◽  
Yuma Ebihara ◽  
Yo Kurashima ◽  
Soichi Murakami ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Postoperative Outcomes ◽  
High Morbidity ◽  
Significant Difference ◽  
Male Patients ◽  
The Impact

Abstract Background It is said that preoperative muscle volume is likely associated with postoperative short- and long-term outcomes in several kinds of cancer by many reports. Esophagectomy for esophageal cancer (EC) is associated with high morbidity and EC has one of the worst prognoses in several kinds of cancer. We investigated the association of preoperative skeletal muscle mass with postoperative outcomes to improve them. Methods We analyzed 150 patients who underwent esophagectomy from February 2002 to March 2016. The cross-sectional area of the psoas muscle index (PMI) was measured at the third lumbar vertebral level using computed tomography. Clavien-Dindo classifications were used to analyze postoperative complications. Since skeletal muscle mass is significantly different according to gender, all analyses were completed by gender (male: 124, female: 26). The Mann-Whitney U test and the chi-square test were used to compare two groups for the analysis of postoperative complications. Multivariate analysis of postoperative complications was performed using a logistic regression model. Survival analyses were performed using a Cox proportional hazard model. Differences were considered to be significant if the P value was less than 0.05. Results In male patients, PMI value was significantly higher in CD≦ II groups than CD≧ III groups. It was also a independent factor for predicting postoperative complications (odds ratio: 0.995, 95% confidence interval: 0.991–0.999, P = 0.02). On the other hand, there was not a significant difference between PMI and overall survival. In female patients, PMI was not associated with postoperative complications and survival. Only pulmonary function (vital capacity percentage) was associated with postoperative complications and survival. Conclusion Preoperative muscle mass was associated with postoperative complications in male patients with EC. In male patients, PMI can be a useful tool to predict postoperative outcomes and select patients who require preoperative nutritional intervention and rehabilitation. Disclosure All authors have declared no conflicts of interest.

Clinical impact of sarcopenia on prognosis in pancreatic ductal adenocarcinoma.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 259-259
Author(s):  
Go Ninomiya ◽  
Tsutomu Fujii ◽  
Suguru Yamada ◽  
Tomonari Asano ◽  
Nao Takano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Adipose Tissue ◽  
Prognostic Factors ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
The Body ◽  
Pancreatic Ductal Carcinoma ◽  
Skeletal Muscle Index ◽  
Significant Difference

259 Background: In the past, various prognostic factors in pancreatic ductal carcinoma (PDAC) have been identified, and there found to be not only tumor-specific clinicopathological factors but also individual patient characteristics. In particular, weight loss, muscle wasting and cachexia are hallmarks of PDAC that may be associated with depletion of both skeletal muscle and adipose tissue. Most notably, sarcopenia is defined to be degenerative loss of skeletal muscle mass that is quantifiable using cross sectional imaging computed tomography (CT) by measurement of psoas area and the muscle’s density. Furthermore, visceral adipose tissue loss also has been reported to associate with a poor survival among patients with PDAC. Methods: A total of 265 patients who underwent curative surgery for PDAC were examined in this study. The total skeletal muscle and fat tissue areas were evaluated in a single image obtained at the third lumber vertebra during a preoperative computed tomography (CT) scan. The patients were assigned to either the sarcopenia or non-sarcopenia group based on their skeletal muscle index (SMI) and classified into high visceral fat area (H-VFA) or low VFA (L-VFA) groups. The association of clinicopathological features and prognosis with the body composition were statistically analyzed. Results: There were 170 patients (64.2%) with sarcopenia. The median survival time (MST) was 23.7 months for sarcopenia patients and 25.8 months for patients without sarcopenia. The MST was 24.4 months for H-VFA patients and 25.8 months for L-VFA patients. However, sarcopenia patients with BMI ≥ 22 exhibited significantly poorer survival than patients without sarcopenia (MST: 19.2 vs. 35.4 months, P = 0.025). There was a significant difference between patients with and without sarcopenia who did not receive chemotherapy (5-year survival rate: 0% vs. 68.3%, P = 0.003). The multivariate analysis revealed that tumor size, positive dissected peripancreatic tissue margin, and sarcopenia were independent prognostic factors. Conclusions: Sarcopenia is an independent prognostic factor in PDAC patients with a BMI ≥ 22. Therefore, evaluating skeletal muscle mass may be a simple and useful approach for predicting patient prognosis.

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