Cachexia index as a prognostic predictor after resection of pancreatic ductal adenocarcinoma

• Published in: Annals of gastroenterological surgery Vol. 7; no. 6; pp. 977 - 986
• Main Authors: Shimagaki, Tomonari, Sugimachi, Keishi, Mano, Yohei, Onishi, Emi, Iguchi, Tomohiro, Nakashima, Yuichiro, Sugiyama, Masahiko, Yamamoto, Manabu, Morita, Masaru, Toh, Yasushi
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.11.2023; John Wiley and Sons Inc; Wiley
• Subjects: Antigens; Blood; Blood platelets; Body mass index; cachexia index; Cancer therapies; Chemotherapy; Classification; Dissection; Immunology; Lymphocytes; Medical prognosis; Metastasis; Neutrophils; Nutritional status; Original; Pancreatic cancer; pancreatic ductal adenocarcinoma; pancreatic resection; Sarcopenia; Surgery; Surgical outcomes; Veins & arteries; Japan; cachexia index; pancreatic resection; pancreatic ductal adenocarcinoma
• ISSN: 2475-0328; 2475-0328
• DOI: 10.1002/ags3.12686

Aim This study was performed to investigate the relationship between the preoperative cachexia index (CXI) and long‐term outcomes in patients who have undergone radical resection of pancreatic ductal adenocarcinoma (PDAC). Methods In total, 144 patients who underwent pancreatic resection for treatment of PDAC were retrospectively analyzed. The relationship between the CXI and the patients' long‐term outcomes after PDAC resection was investigated. The CXI was calculated based on the preoperative skeletal muscle index, serum albumin level, and neutrophil‐to‐lymphocyte ratio. After propensity‐score matching, we compared clinicopathological features and outcomes. Results The multivariate analysis showed that lymph node metastasis (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.16–3.23; P = 0.0118), R1 resection (HR, 57.20; 95% CI, 9.39–348.30; P < 0.0001), and a low CXI (HR, 2.10; 95% CI, 1.27–3.46; P = 0.0038) were independent and significant predictors of disease‐free survival (DFS) after PDAC resection. Moreover, a low CXI (HR, 3.14; 95% CI, 1.71–5.75; P = 0.0002) was an independent and significant predictor of overall survival (OS) after PDAC resection. After propensity‐score matching, the low CXI group had a significantly worse prognosis than the high CXI group for both DFS and OS. Conclusion The CXI can be a useful prognostic factor for DFS and OS after pancreatic resection for treatment of PDAC. The CXI can be a useful prognostic factor for disease‐free survival and overall survival after pancreatic resection for treatment of PDAC.