Skeletal Muscle Loss and Octogenarian Status Are Associated with S-1 Adjuvant Therapy Discontinuation and Poor Prognosis after Pancreatectomy

The efficacy and prognosis of adjuvant chemotherapy for resected pancreatic cancer remain unclear. We investigated the utility and risk factors of S-1 adjuvant chemotherapy in patients with pancreatic cancer undergoing pancreatectomy. This study comprised 80 patients, including 58 patients who received S-1 adjuvant chemotherapy. Skeletal muscle loss was defined using cutoff values of skeletal muscle mass index. In total, 16 (20%) octogenarian patients underwent pancreatectomy. Skeletal muscle loss was present in 56 (70%) patients. The entire course of S-1 adjuvant chemotherapy for 6 months was completed in 33 patients (41%). S-1 adjuvant chemotherapy <6 months was an independent prognostic indicator of poor overall survival. Patients who completed S-1 adjuvant chemotherapy exhibited significantly longer overall and relapse-free survival rates than those did not complete the chemotherapy (p <0.0001 and p = 0.0003, respectively). Being an octogenarian and skeletal muscle loss were independent variables associated with the discontinuation of S-1 adjuvant chemotherapy. Finally, the S-1 adjuvant chemotherapy rates were 6.3% (1/16) and 28.6% (16/56) in octogenarian patients and those with skeletal muscle loss, respectively. S-1 adjuvant chemotherapy completion was associated with improved prognosis in patients with pancreatic cancer. Skeletal muscle loss and octogenarian status predicted the failure of S-1 adjuvant chemotherapy completion.

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Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.168 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 168-168

Author(s):

Kazumasa Fujitani ◽

Yusuke Yamaoka ◽

Toshimasa Tsujinaka ◽

Kazuyoshi Yamamoto ◽

Motohiro Hirao ◽

...

Keyword(s):

Skeletal Muscle ◽

Adipose Tissue ◽

Adjuvant Chemotherapy ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Significant Loss ◽

Muscle Loss ◽

Clinical Factors ◽

Improved Outcomes ◽

Skeletal Muscle Loss

168 Background: Skeletal muscle loss is associated with physical disability, nosocomial infections, postoperative complications, and decreased survival. Preventing the loss of skeletal muscle mass after gastrectomy may lead to improved outcomes. The aims of this study were to assess changes in skeletal muscle mass after total gastrectomy (TG) and to clarify the clinical factors affecting significant loss of skeletal muscle after TG. Methods: One hundred and two patients undergoing TG for primary gastric cancer underwent abdominal computed tomography (CT) before and 1 year after TG to precisely quantify postoperative changes in skeletal muscle and adipose tissue. Univariate and multivariate logistic regression analyses identified clinical factors contributing to significant loss of skeletal muscle after TG. Results: At 1 year after TG, the mass of both skeletal muscle and adipose tissue was reduced by 6.20±6.80% and 65.8±36.1% of the preoperative values, respectively, and 26 patients (25.5%) showed a significant loss of skeletal muscle of more than 10%. Adjuvant chemotherapy with S-1 for ≥6 months (hazard ratio 26.75, 95% confidence interval 3.511 to 203.9) was identified as the single independent risk factor for a significant loss of skeletal muscle. Conclusions: Skeletal muscle loss was exacerbated by extended adjuvant chemotherapy after TG. Further research should identify appropriate nutritional interventions for maintaining skeletal muscle mass and leading to improved outcomes.

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Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

Gastric Cancer ◽

10.1007/s10120-014-0365-z ◽

2014 ◽

Vol 18 (2) ◽

pp. 382-389 ◽

Cited By ~ 25

Author(s):

Yusuke Yamaoka ◽

Kazumasa Fujitani ◽

Toshimasa Tsujinaka ◽

Kazuyoshi Yamamoto ◽

Motohiro Hirao ◽

...

Keyword(s):

Skeletal Muscle ◽

Adjuvant Chemotherapy ◽

Total Gastrectomy ◽

Muscle Loss ◽

Skeletal Muscle Loss

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Skeletal Muscle Loss During Neoadjuvant Chemotherapy Predicts Poor Prognosis in Patients with Breast Cancer

10.21203/rs.3.rs-857977/v1 ◽

2021 ◽

Author(s):

Masatsugu Amitani ◽

Takaaki Oba ◽

Hiroki Morikawa ◽

Tatsunori Chino ◽

Ai Soma ◽

...

Keyword(s):

Breast Cancer ◽

Skeletal Muscle ◽

Neoadjuvant Chemotherapy ◽

Poor Prognosis ◽

Disease Free Survival ◽

Prognostic Impact ◽

Muscle Loss ◽

Free Survival ◽

Skeletal Muscle Loss ◽

Disease Free

Abstract Background: The skeletal muscle index (SMI), which is calculated as the ratio of skeletal muscle area at the third lumbar vertebral level divided by height squared, has been considered a prognostic factor in patients with breast cancer. However, the prognostic impact of changes in SMI during treatment remains unclear. This study aimed to evaluate the influence of SMI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC).Methods: We reviewed patients with breast cancer who underwent NAC and subsequent surgery for breast cancer between 2010 and 2017. The rate of SMI change during NAC was calculated, and the association between SMI changes and prognosis was retrospectively analyzed.Results: In total, 144 patients were evaluated. 48 (33.3%), 56 (38.9%), and 40 (27.8%) patients exhibited increased (≥ 3%), maintained (−3% <, < 3%), and decreased (−3% ≥) SMI during NAC, respectively. The decreased SMI group showed significantly poorer disease-free survival than the maintained and increased SMI groups (hazard ratio [HR] 8.82, p < 0.001 for the decreased vs. increased SMI groups; HR 3.72, p < 0.001 for the decreased vs. maintained SMI groups). Moreover, decreased SMI was an independent risk factor for disease-free survival in multivariate analysis (HR 4.20, p < 0.01).Conclusions: Skeletal muscle loss during NAC predicts poor prognosis. Our results underscore the importance of monitoring and maintaining skeletal muscle mass during NAC.

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