Effect of pretreatment psoas muscle mass on survival for patients with unresectable pancreatic cancer undergoing systemic chemotherapy

Abstract

Abstract. To the best of our knowledge, there are few previous studies that have investigated the effect of decreased skeletal muscle mass (DSMM) on survival in patients with unresectable advanced pancreatic cancer (APC) who are undergoing systemic chemotherapy. Thus, the present study aimed to investigate the impact of DSMM, as determined by the psoas muscle index (PMI) following computed tomography and prior to systemic chemotherapy, on the outcomes of patients with unresectable APC (n=61). The primary endpoint used was the overall survival (OS) rate. The OS rates in the PMI-High group (exceeds the median PMI value in each gender) were retrospectively compared with those in the PMI-Low group (below the median PMI value in each gender), and factors associated with OS were investigated using univariate and multivariate analyses. The study cohort included 31 male and 30 female patients with a median age of 72 years, 13 of whom were stage IVA, and 48 were stage IVB. ). The proportion of patients with performance status 0 in the PMI-High group was significantly high, compared with that in the PMI-Low group [83.3% (25/30) vs. 58.1% (18/31); P=0.0486]. Body mass index in the PMI-High group was significantly higher compared with that in the PMI-Low group (P=0.0154). The 1-year cumulative survival rate was 43.3% in the PMI-High group and 12.9% in the PMI-Low group (P=0.0027). Following multivariate analysis, PMI (P=0.0036), prothrombin time (P=0.0044) and carbohydrate antigen 19-9 (P= 0.0451) were identified to be significant predictors of OS. In conclusion, DSMM, as determined by the PMI, could be a significant predictor of prognosis in patients with unresectable APC who are receiving systemic chemotherapy.

Prognostic Role of Muscle Depletion in Palliative Care Patients With Incurable Cancer: A Retrospective Study

“…PMI, which is a measure of muscle mass, was an independent prognostic factor in palliative care patients. PMI measurement has been widely used as an alternative method for evaluating all major skeletal muscles at the lumbar level, and PMI has been associated with prognosis in patients with cancer [22,23] and with surgical outcomes [24]. However, the previous studies have examined patients receiving anticancer therapy with a prognosis of more than several months.…”

Proposal of predictive model on survival in unresectable pancreatic cancer receiving systemic chemotherapy

“…Next, we evaluated the reproducibility of the proposed model in the subsequent Vs (n=75), which included patients in the other hospital (Takarazuka municipal hospital). (Figure 1) Clinical data in the Ts were examined retrospectively and the constructed model was also verified in a retrospective manner for the independent Vs. Psoas muscle index (PMI) for the assessment of muscle mass was measured using CT as reported elsewhere [30].…”

Effect of exercise therapy on sarcopenia in pancreatic cancer: a study protocol for a randomised controlled trial

“…Standard therapies such as surgical resection and systemic chemotherapy will be chosen based on tumour status and baseline characteristics in each patient after thorough discussion with surgeons and oncologists. 20 27 …”

“… 18 19 In our previous investigation, we demonstrated that decreased skeletal muscle mass could be a significant predictor of prognosis in patients with unresectable advanced PC undergoing systemic chemotherapy, and some interventions for patients with sarcopenic PC could be beneficial for ameliorating clinical outcomes. 20 …”