Prognostic significance of sarcopenia as determined by bioelectrical impedance analysis in patients with advanced pancreatic cancer receiving gemcitabine plus nab‑paclitaxel: A retrospective study

Abstract

Sarcopenia often affects patients with various types of cancer, and has been reported to affect patient prognosis and therapeutic effects. However, to the best of our knowledge, there are no reports on the relationship between gemcitabine plus nab-paclitaxel combination therapy (GnP) and sarcopenia in patients with unresectable pancreatic cancer. The present study analyzed the relationship between overall survival (OS), progression-free survival (PFS), response rate, disease control rate, adverse events (AEs) and sarcopenia in patients with pancreatic cancer treated with GnP. A total of 121 consecutive patients with advanced pancreatic cancer who received GnP as first-line chemotherapy between January 2015 and December 2017 were retrospectively analyzed. GnP consisted of 1,000 mg/m 2 gemcitabine and 125 mg/m 2 nab-paclitaxel, which were administered on days 1, 8 and 15 every 4 weeks. The skeletal muscle index (SMI) was calculated using bioimpedance analysis (BIA) as an index of sarcopenia prior to GnP. The patients were divided into sarcopenia (n=41) and non-sarcopenia (n=80) groups using cutoff values of 8.87 and 6.42 kg/m 2 for male and female patients, respectively. The sarcopenia and non-sarcopenia groups had a median OS of 8.1 and 13.9 months, respectively [hazard ratio (HR) 0.79; 95% confidence interval (CI) 0.53-1.20], and a median PFS of 4.3 and 6.3 months, respectively (HR 0.63; 95% CI 0.42-0.95). The response and disease controls rate were not statistically different between the groups (20 vs. 32%, P=0.20; 81 vs. 80%, P=1.0). In addition, comparison of common grade 3 and 4 AEs between the two groups revealed no statistically significant differences. In conclusion, the results of the present study indicated that SMI obtained by BIA may be a predictor of treatment response and prognosis in patients with advanced pancreatic cancer who undergo GnP.

Effect of body fat mass loss on prognosis of radical resection for pancreatic ductal adenocarcinoma based on bioelectrical impedance analysis

“…Gupta et al reported that the phase angle used as an index for evaluating cell membranes and intra-and extracellular water balance was a strong prognostic indicator in advanced PDAC, and patients with a phase angle > 5.0° had a signi cantly better prognosis than those with a phase angle < 5.0° (MST, 10.2 vs 6.3 months, p = 0.02) [26]. Additionally, Tozuka, et al revealed that SMI obtained by BIA may be a predictor of treatment response and prognosis in patients with advanced PDAC who underwent gemcitabine plus nab-paclitaxel combination therapy, and the progression-free survival in the sarcopenia group was signi cantly lower compared with that of the non-sarcopenia group (4.4 vs 6.4 months, p = 0.03) [27]. In the current study, the SMM did not change signi cantly, while the BFM changed signi cantly from preoperatively to 12 months postoperatively; therefore, we speculated that the rate of BFM change may be a sensitive re ection of malnutrition related to prognosis.…”