Cancer treatment and research communications · 2026
Drastic muscle wasting following surgery is a strong predictor of prognosis in early-stage pancreatic cancer-a Taiwanese multicenter cohort study.
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Chen Chien-Yu, Hou Ya-Chin, Chao Ying-Jui, Kan Na-Ning, Wang Ming-Hung, Liu Yueh-Wei, Lin Yu-Hung, Wang Chih-Jung, Huang Chien-Jui, Chiu Tai-Jan, Yin Shih-Min, Shan Yan-Shen
Аннотация
OBJECTIVE: To clarify the impact of preoperative sarcopenia and muscle wasting postoperative on the short- and long-term outcomes following pancreatectomy in resectable pancreatic cancer (PC) patients.
SUMMARY BACKGROUND DATA: Previous studies revealed that sarcopenia, defined as generalized loss of skeletal muscle mass, was a poor prognosis factor following surgery. However, research focus on postoperative muscle wasting and their influences on the prognosis in resectable PC was very limited.
METHODS: Retrospective analysis was performed for 284 early-stage PC patients who underwent pancreatic resection in two medical centers. Preoperative psoas major area and the degree of muscle reduction postoperative 3 months were calculated by computed tomography to define sarcopenia and drastic muscle wasting. Patients were assigned to 2 groups based on the presence or absence of sarcopenia or drastic muscle wasting and compared for postoperative morbidity and survival rate.
RESULTS: Sarcopenia was present in 149 of 284 patients (52.4%), and a total of 88 patients (31.0%) developed muscle wasting of over 17% postoperatively. Compared with non-sarcopenia group, patients with sarcopenia had significantly greater incidence of overall or major morbidity (P = 0.001; P = 0.038, respectively), while sarcopenia status didn't correlate with poor-long term survival (DFS, P = 0.812; OS, P = 0.238). Surprisingly, patients presented drastic muscle wasting displayed poor DFS (P < 0.001) and OS (P < 0.001) and were found to be independent predictors of unfavorable DFS (P = 0.005) and OS (P < 0.001) after adjusting for clinicopathologic parameters.
CONCLUSIONS: Sarcopenia preoperative is associated with higher risk of morbidity. Moreover, the concept of assessment in wasting muscle quantity following pancreatectomy is essential for accurate long-term prognosis in resectable PC patients.
SUMMARY BACKGROUND DATA: Previous studies revealed that sarcopenia, defined as generalized loss of skeletal muscle mass, was a poor prognosis factor following surgery. However, research focus on postoperative muscle wasting and their influences on the prognosis in resectable PC was very limited.
METHODS: Retrospective analysis was performed for 284 early-stage PC patients who underwent pancreatic resection in two medical centers. Preoperative psoas major area and the degree of muscle reduction postoperative 3 months were calculated by computed tomography to define sarcopenia and drastic muscle wasting. Patients were assigned to 2 groups based on the presence or absence of sarcopenia or drastic muscle wasting and compared for postoperative morbidity and survival rate.
RESULTS: Sarcopenia was present in 149 of 284 patients (52.4%), and a total of 88 patients (31.0%) developed muscle wasting of over 17% postoperatively. Compared with non-sarcopenia group, patients with sarcopenia had significantly greater incidence of overall or major morbidity (P = 0.001; P = 0.038, respectively), while sarcopenia status didn't correlate with poor-long term survival (DFS, P = 0.812; OS, P = 0.238). Surprisingly, patients presented drastic muscle wasting displayed poor DFS (P < 0.001) and OS (P < 0.001) and were found to be independent predictors of unfavorable DFS (P = 0.005) and OS (P < 0.001) after adjusting for clinicopathologic parameters.
CONCLUSIONS: Sarcopenia preoperative is associated with higher risk of morbidity. Moreover, the concept of assessment in wasting muscle quantity following pancreatectomy is essential for accurate long-term prognosis in resectable PC patients.