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Impact of skeletal muscle mass on the prognosis of patients undergoing neoadjuvant chemotherapy for resectable or borderline resectable pancreatic cancer

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Abstract

Background

Neoadjuvant chemotherapy is a common therapeutic procedure for patients with pancreatic cancer. This study aimed to investigate the association between the total psoas area (TPA) and prognosis in patients undergoing neoadjuvant chemotherapy for resectable or borderline resectable pancreatic cancer.

Study design

This retrospective study included patients who underwent neoadjuvant chemotherapy for pancreatic cancer. TPA was measured at the level of the L3 vertebra using computed tomography. The patients were divided into low-TPA and normal-TPA groups. These dichotomizations were separately performed in patients with resectable and those with borderline resectable pancreatic cancer.

Results

In total, 44 patients had resectable pancreatic cancer and 71 patients had borderline resectable pancreatic cancer. Overall survival among patients with resectable pancreatic cancer did not differ between the normal- and low-TPA groups (median, 19.8 vs. 21.8 months, p = 0.447), whereas among patients with borderline resectable pancreatic cancer, the low-TPA group had shorter overall survival than the normal-TPA group (median, 21.8 vs. 32.9 months, p = 0.006). Among patients with borderline resectable pancreatic cancer, the low-TPA group was predictive of poor overall survival (adjusted hazard ratio, 2.57, p = 0.037).

Conclusion

Low TPA is a risk factor of poor survival in patients undergoing neoadjuvant chemotherapy for borderline resectable pancreatic cancer. TPA evaluation could potentially suggest the treatment strategy in this disease.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy reasons.

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Acknowledgements

We sincerely thank all the patients, collaborating physicians, and other medical staff for their important contributions to this study.

Funding

The authors affirm that they have no financial or personal affiliations (including research funding) or other involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showaku, Nagoya, Aichi, 466-8550, Japan

    Hiroki Nakajima, Junpei Yamaguchi, Nobuyuki Watanabe, Shunsuke Onoe, Takashi Mizuno, Yukihiro Yokoyama & Tomoki Ebata

  2. Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan

    Hiroki Nakajima & Yoshihiro Nishida

  3. Department of Gastroenterological Surgery (Surgery II), Nagoya University Hospital, Nagoya, Japan

    Hideki Takami, Masamichi Hayashi & Yasuhiro Kodera

Authors
  1. Hiroki Nakajima
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  2. Junpei Yamaguchi
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  3. Hideki Takami
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  4. Masamichi Hayashi
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  5. Yasuhiro Kodera
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  6. Yoshihiro Nishida
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  7. Nobuyuki Watanabe
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  8. Shunsuke Onoe
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  9. Takashi Mizuno
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  10. Yukihiro Yokoyama
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  11. Tomoki Ebata
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Contributions

HN: conceptualization, data curation, writing. JY: data curation. HT: data curation. MH: data curation. YK: data curation. YN: data curation. NW: data curation. SO: data curation. TM: data curation. YY: conceptualization, data curation, writing, validation. TE: conceptualization, validation.

Corresponding author

Correspondence to Yukihiro Yokoyama.

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Supplementary Information

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10147_2023_2321_MOESM1_ESM.pptx

Supplementary file1 Supplementary Fig. 1 Abdominal computed tomography image at the level of the third lumbar vertebra. The right and left psoas muscle areas, which comprise the total psoas muscle area (TPA), were traced (dotted line). Normalized TPA = measured TPA [mm2]/height [m]2. Supplementary Fig. 2 Kaplan–Meier curves for recurrence free survival in patients with (A) resectable pancreatic cancer and (B) borderline resectable pancreatic cancer. (PPTX 203 kb)

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Nakajima, H., Yamaguchi, J., Takami, H. et al. Impact of skeletal muscle mass on the prognosis of patients undergoing neoadjuvant chemotherapy for resectable or borderline resectable pancreatic cancer. Int J Clin Oncol 28, 688–697 (2023). https://doi.org/10.1007/s10147-023-02321-1

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  • DOI: https://doi.org/10.1007/s10147-023-02321-1

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