Abstract
Previous studies on changes in body composition of pancreatic cancer patients have only focused on short-term survivors. We studied longitudinal body composition changes and factors affecting them in long-term survivors by analyzing many abdominal computed tomography images using artificial intelligence technology. Of 302 patients who survived for >36 months after surgery were analyzed. Multivariate logistic regression analysis for factors affecting body composition changes and repeated-measures analysis of variance to observe differences in the course of change according to each factor were performed. In logistic analysis, preoperative sarcopenia and recurrence were the main factors influencing body composition changes at 1 and 3 years after surgery, respectively. In changes of longitudinal body composition, the decrease in body composition was the greatest at 3–6 months postoperatively, and the preoperative status did not recover even 3 years after surgery. Especially, males showed a greater reduction in skeletal muscle (SKM) after surgery than females (p < 0.01). In addition, SKM (p < 0.001) and subcutaneous adipose tissue (p < 0.05) mass rapidly decreased in case of recurrence. In conclusion, long-term survivors of pancreatic cancer did not recover their preoperative body composition status, and preoperative sarcopenia and recurrence influenced body composition changes.
Highlights
The overall and recurrence-free survival of pancreatic cancer is increasing due to advances in diagnosis and treatment technology, but its prognosis is poor [1]
In addition to survival issues, approximately 70–80% of patients with pancreatic cancer develop cachexia, a significant loss of skeletal muscle (SKM) and adipose tissue (AT) mass, owing to increased systemic inflammation caused by factors such as activation of the catabolic pathway in the tumor itself [2]; problems after surgery such as exocrine pancreatic insufficiency, abdominal pain, and motility disturbance of the upper gastrointestinal tract [3]; and adjuvant treatments such as chemotherapy [4]
We found that SKM mass had a lower risk of reduction during survival if preOP sarcopenia was present
Summary
The overall and recurrence-free survival of pancreatic cancer is increasing due to advances in diagnosis and treatment technology, but its prognosis is poor [1]. Patients with pancreatic cancer undergo body composition changes during their survival period. The change was greater in cases with diabetes and anemia at the time of diagnosis of pancreatic cancer [5]. Dalal et al indicated that SKM mass decreased by 4% and VAT and subcutaneous AT (SAT) mass decreased by 15% and 11%, respectively, during adjuvant treatment of locally advanced pancreatic cancer. The study reported that the higher the patient’s body mass index (BMI) and VAT index, the greater the loss of SKM mass [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
