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Decreased Skeletal Muscle Volume Is a Predictive Factor for Poorer Survival in Patients Undergoing Surgical Resection for Pancreatic Ductal Adenocarcinoma

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The aim of this study was to investigate the impact of decreased skeletal muscle (SM) volume on survival outcomes in patients undergoing surgical resection for pancreatic ductal adenocarcinoma (PDAC).

Methods

Between March 2000 and February 2015, 323 patients who underwent upfront surgical resection for PDAC were identified from the Mayo Clinic SPORE in Pancreatic Cancer. Body composition data, including SM area, subcutaneous adipose tissue area, and visceral adipose tissue area were calculated using an abdominal computed tomography (CT) image at the third lumbar spinal level. The body composition data were normalized by patients’ height (e.g., SM index, cm2/m2) and analyzed as continuous variables. Clinicopathological findings and body composition data at initial diagnosis were evaluated for association with overall survival and recurrence-free survival.

Results

Because the median SM index was significantly different between males vs. females (49.9 cm2/m2 [range, 32.0–70.3] vs. 39.4 cm2/m2 [range, 29.2–66.2], P < 0.001), it was standardized for each sex and used for further analyses. Parameters independently associated with a shorter overall survival were a larger tumor size (P = 0.007), a greater tumor extent (P = 0.037), a higher carbohydrate antigen 19–9 level (P < 0.001), and a smaller sex-standardized SM index (P = 0.011). Parameters independently associated with a shorter recurrence-free survival were female sex (P = 0.029), a larger tumor size (P < 0.001), a higher carbohydrate antigen 19–9 level (P = 0.001), and a smaller sex-standardized SM index (P = 0.007).

Conclusions

A smaller sex-standardized SM index is a predictive factor for shorter overall and recurrence-free survival in PDAC patients undergoing surgery.

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Acknowledgements

The authors thank William R. Bamlet, M.S., and Brendan Broderick for their contributions. This study was supported in part by a NIH grant P50CA102701, Mayo Clinic SPORE in Pancreatic Cancer.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Subspecialty General Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Motokazu Sugimoto, Michael B. Farnell, David M. Nagorney, Michael L. Kendrick, Mark J. Truty & Rory L. Smoot

  2. Department of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Suresh T. Chari

  3. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Michael R. Moynagh & Naoki Takahashi

  4. Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Gloria M. Petersen & Rickey E Carter

Authors
  1. Motokazu Sugimoto
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  2. Michael B. Farnell
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  4. Michael L. Kendrick
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  11. Naoki Takahashi
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Contributions

Sugimoto designed the study, and wrote the initial draft of the manuscript. Takahashi contributed to the interpretation of the data and the critical revision of the manuscript for important intellectual content. All the other authors (Farnell, Nagorney, Kendrick, Truty, Smoot, Chari, Moynagh, Petersen, and Carter) contributed to the data collection and interpretation and critically reviewed the manuscript. All the authors have read and approved the final version of the manuscript, and have agreed to be accountable for all aspects of the study, ensuring that any questions related to the accuracy or integrity of any part of the work are answerable.

Corresponding author

Correspondence to Naoki Takahashi.

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The study was approved by the Mayo Clinic’s Institutional Review Board.

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Sugimoto, M., Farnell, M.B., Nagorney, D.M. et al. Decreased Skeletal Muscle Volume Is a Predictive Factor for Poorer Survival in Patients Undergoing Surgical Resection for Pancreatic Ductal Adenocarcinoma. J Gastrointest Surg 22, 831–839 (2018). https://doi.org/10.1007/s11605-018-3695-z

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  • DOI: https://doi.org/10.1007/s11605-018-3695-z

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