Journal Article

Prognostic Significance of Muscle Attenuation in Pancreatic Cancer Patients Treated with Neoadjuvant Chemoradiotherapy

Hasegawa, Masatoshi, Akahori, Takahiro, Nagai, Minako, Kinoshita, Shoichi, Ohbayashi, Chiho, Tamamoto, Tetsuro, Nakajima, Yoshiyuki, Tanaka, Toshihiro, Sho, Masayuki, Nishiwada, Satoshi, Kichikawa, Kimihiko

2015

Overview

Background Emerging evidences have gradually revealed the skeletal muscle attenuation (MA) was not only reflected the accumulation of lipids in skeletal muscle but also associated with physiological and pathological states. The aim of this study was to evaluate the impact of MA on the prognosis of pancreatic cancer patients treated with neoadjuvant chemoradiotherapy (NACRT). Methods Eighty-three patients with pancreatic cancer who received NACRT were enrolled. Patients were divided according to their Hounsfield units of the skeletal muscle at the third lumbar vertebra in CT. The lower quartile was defined as MA group and the remainder as control group. Results There was no significant difference in overall survival between pre-NACRT MA and control groups. In contrast, patients with post-NACRT MA had a significantly poorer prognosis than patients without. The patients in the post-NACRT MA group were significantly older than patients in the control group. There were no significant differences in most clinicopathological and perioperative factors between both groups. However, patients with post-NACRT MA had a longer hospital stay than patients without. Furthermore, the incompletion rate of the proposed adjuvant chemotherapy was significantly higher in the MA group than control. Importantly, multivariate analysis indicated that post-NACRT MA was an independent prognostic factor. Conclusions Muscle attenuation may have a significant impact in pancreatic cancer patients treated with multimodal therapy. Therefore, our data may provide new insights into perioperative patient care to improve the prognosis of resectable pancreatic cancer.

• Publisher: Springer International Publishing,John Wiley & Sons, Inc
• Subject: Abdominal Surgery / Adenocarcinoma - therapy / Aged / Back Muscles - diagnostic imaging / Cardiac Surgery / Chemoradiotherapy / Female / Gemcitabine / General Surgery / Hounsfield Unit / Humans / Length of Stay / Lumbosacral Region / Male / Medicine / Medicine & Public Health / Middle Aged / National Comprehensive Cancer Network / Neoadjuvant Therapy / Original Scientific Report / Pancreatic Cancer / Pancreatic Neoplasms - therapy / Planning Target Volume / Prognosis / Surgery / Survival Rate / Thoracic Surgery / Tomography, X-Ray Computed / Vascular Surgery