O1-17-1 - Characterization of a loss of skeletal muscle mass in advanced pancreatic cancer patients receiving chemotherapy

Abstract

Background: A loss of skeletal muscle mass (SMM) represents a clinical feature of cancer cachexia implying poor quality of life (QOL) and poor prognosis. It is possible that atrophy of SMM is started in first-line chemotherapy for advanced pancreatic cancer (PCa) and is related to the deterioration of symptoms and QOL. The goal of this study was to identify decreasing SMM-related factors in advanced PCa patients receiving first-line chemotherapy. Methods: Advanced PCa patients who were scheduled to receive first-line chemotherapy were eligible in this study. Body composition, symptoms, and QOL were prospectively evaluated at baseline and one month later using bioelectrical impedance analysis and questionnaire (Japanese version of the M.D. Anderson Symptom Inventory). Patients in whom SMM was reduced at one month after the start of chemotherapy were assigned to atrophy group. The differences between atrophy and non-atrophy group were examined at baseline or one month later. Landmark analysis was used for overall survival (OS) analysis. Results: 131 patients (male: 55.7%, age in mean: 65.3 years, Karnofsky Performance Status (KPS) in mean: 90.1, mean body weight: 55.4 kg, mean BMI: 21.4 kg/m2, mean SMM: 22.6 kg) were evaluated. There were no differences in baseline characteristics between atrophy group (n = 63, change of SMM in mean: -1.5 kg) and non-atrophy group (n = 68, +1.7 kg). At 1 month later, KPS score in atrophy group were lower than that in non-atrophy group (KPS: 84.2 vs 88.8, P=0.04). QOL scores of work and walking in atrophy group were worsen to be compared with those in non-atrophy group (work: 3.6 vs 2.3, P=0.01, walking: 2.9 vs 2.0, P=0.04). Survival analysis revealed that atrophy group showed poor OS, compared to non-atrophy group (4.5 vs 7.7 mo, P<0.01). Conclusion: A loss of skeletal muscle mass in first-line chemotherapy for advanced PCa related to the deterioration of physical activity and poor OS.