Relationships among body mass index, longitudinal body composition alterations, and survival in patients with locally advanced pancreatic cancer receiving chemoradiation: a pilot study
Journal of Pain and Symptom Management, 06/29/2012
Dalal S et al. – These preliminary findings suggest that obese patients experience higher losses in weight, SKM, and VAT, which may contribute to poorer survival in these patients.Methods
- Records of 41 patients with inoperable locally advanced pancreatic cancer who participated in a prospective chemoradiation study were reviewed.
- Body composition was analyzed from two sets of computed tomography images obtained before and after radiation treatment (median interval 104 days).
- Median age was 59 years and 56% of patients female.
- 24 (59%) patients were either overweight (22%) or obese (37%).
- Sarcopenia was present in 26 (63%) patients.
- At follow–up, weight loss was experienced by 33 (81%) patients.
- The median losses (%) before and after treatment were weight 5% (P<0.001), skeletal muscle (SKM) 4% (P=0.003), visceral adipose tissue (VAT) 13% (P<0.001), and subcutaneous adipose tissue 11% (P=0.002).
- SKM loss positively correlated with age (P=0.03), baseline body mass index (P<0.001), and VAT (P=0.04) index.
- Obese patients experienced higher losses in weight (P=0.009), SKM (P=0.02), and VAT (P=0.02).
- Median survival was 12 months.
- In univariate analysis, age, baseline obesity, sarcopenic obesity, and losses (%) in weight, SKM, and VAT were associated with worse survival.
- In multivariate analysis, only age (hazard ratio=1.033, P=0.04, and higher VAT loss [hazard ratio=2.6 and P=0.03]) remained significant.