Sarcopenia as a prognostic factor in patients with recurrent pancreatic cancer: a retrospective study
Sarcopenia as a prognostic factor in patients with recurrent pancreatic cancer: a retrospective study
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DOI：
10.1186/s12957-020-01981-x
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发表时间：
2020-08-22
影响因子：
3.2
通讯作者：
Fujiwara, Yoshiyuki
中科院分区：
文献类型：
--
作者：
Sakamoto, Teruhisa;Yagyu, Takuki;Fujiwara, Yoshiyuki
背景肌肉减少症是多种癌症的预后因素。然而，肌肉减少症对复发性胰腺癌患者的影响仍不清楚。本研究评估了肌肉减少症对复发性胰腺癌患者的预后意义。方法 纳入74例胰腺癌术后复发患者。这些患者的肌少症是根据第三椎骨计算机断层扫描测量的腰肌指数（PMI）来定义的。结果 复发时的平均 PMI 男性为 4.47 +/- 1.27 cm(2)/m(2)，女性为 3.26 +/- 0.70 cm(2)/m(2)。在 74 名患者中，65 名（87.8%）被诊断为低 PMI 肌少症。肌少症组的2年复发后生存曲线显着差于非肌少症组（P=0.034）。多变量分析显示，复发时的肌少症是复发性胰腺癌患者的独立预后因素（P = 0.043），此外，中性粒细胞与淋巴细胞比率高（P = 0.004）、早期复发（P = 0.001）和复发后化疗（P = 0.005）。此外，肌少症与复发时间联合预测 2 年生存率的曲线下面积 (AUC) 为 0.763，远高于单独肌少症的曲线下面积 (AUC = 0.622)。结论 肌肉减少症是复发性胰腺癌患者的一个有用的预后因素。肌肉减少症和复发时间的结合可能比单独的肌肉减少症更准确地预测复发后生存。
Background Sarcopenia is a prognostic factor in various cancers. However, the impact of sarcopenia in patients with recurrent pancreatic cancer remains unclear. This study evaluated the prognostic significance of sarcopenia in patients with recurrent pancreatic cancer. Methods Seventy-four patients who developed postoperative recurrence of pancreatic cancer after undergoing pancreatectomies were enrolled. Sarcopenia in these patients was defined according to the psoas muscle index (PMI) measured via computed tomography at the third vertebra. Results The mean PMIs at the time of recurrence were 4.47 +/- 1.27 cm(2)/m(2)for men and 3.26 +/- 0.70 cm(2)/m(2)for women. Of the 74 patients, 65 (87.8%) were diagnosed with sarcopenia with low PMI. The 2-year post-recurrence survival curve in the sarcopenia group was significantly worse than that in the non-sarcopenia group (P= 0.034). Multivariate analysis revealed that sarcopenia at the time of recurrence was an independent prognostic factor (P= 0.043) along with a high neutrophil-to-lymphocyte ratio (P= 0.004), early recurrence (P= 0.001), and chemotherapy after recurrence (P= 0.005) in patients with recurrent pancreatic cancer. Furthermore, the area under the curve (AUC) of the combination of sarcopenia and time to recurrence for predicting 2-year survival was 0.763, which was much higher than that of sarcopenia alone (AUC = 0.622). Conclusions Sarcopenia is a useful prognostic factor in patients with recurrent pancreatic cancer. The combination of sarcopenia and time of recurrence may more accurately predict post-recurrence survival than can sarcopenia alone.