Published online Dec 27, 2022. doi: 10.4240/wjgs.v14.i12.1350
Peer-review started: September 16, 2022
First decision: October 20, 2022
Revised: October 29, 2022
Accepted: December 6, 2022
Article in press: December 6, 2022
Published online: December 27, 2022
Processing time: 102 Days and 4.9 Hours
The only potential curative treatment for patients with pancreatic cancer is surgery; however, the prognosis remains poor.
Measures of body composition based on computed tomography (CT) scans have been established as reliable predictors of the prognosis of cancer patients after surgery, but further research focusing on pancreatic cancer is needed.
To elucidate the associations of body composition measures derived from preoperative CT scans with the prognosis of patients with pancreatic cancer.
One hundred fifteen patients undergoing pancreatic resection with curative intent for pancreatic cancer were retrospectively enrolled. The preoperative CT scan at the third lumbar vertebral level was measured for skeletal muscle index (SMI), mean skeletal muscle radiodensity, subcutaneous adipose tissue index, visceral adipose tissue index, and subcutaneous adipose tissue area ratio. The clinical and pathological data were collected. The effects of these factors on long-term survival were evaluated.
Among the five body composition measures, only low SMI independently predicted overall survival (OS) [hazard ratio (HR): 2.307; 95% confidence interval (CI): 1.210-4.402] and recurrence-free survival (HR: 1.907; 95%CI: 1.147-3.171). Furthermore, patients with low SMI (vs high SMI) were older (68.8 ± 9.3 years vs 63.3 ± 8.4 years); low SMI was present in 27 of 56 patients (48.2%) aged 65 years and older and in 11 of 59 younger patients (18.6%). In addition, subgroup analyses revealed that the correlation between low SMI and OS was observed only in patients aged 65 years and older.
Low preoperative SMI was more prevalent in elderly patients and was associated with a poor prognosis among pancreatic cancer patients, especially elderly patients.
The early identification of aging-specific factors, such as low SMI, allows for the possibility to facilitate early interventions to ameliorate clinical outcomes in elderly patients with pancreatic cancer.