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Annals of Surgical Oncology
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27-12-2022 | Pancreatectomy | Pancreatic Tumors

Change Impact of Body Composition During Neoadjuvant Chemoradiotherapy in Patients with Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma Undergoing Pancreatectomy

Authors: Shohei Takaichi, MD, PhD, Yoshito Tomimaru, MD, PhD, Shogo Kobayashi, MD, PhD, Keisuke Toya, MD, Kazuki Sasaki, MD, PhD, Yoshifumi Iwagami, MD, PhD, Daisaku Yamada, MD, PhD, Takehiro Noda, MD, PhD, Hidenori Takahashi, MD, PhD, Tadafumi Asaoka, MD, PhD, Masahiro Tanemura, MD, PhD, Yuichiro Doki, MD, PhD, Hidetoshi Eguchi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2023

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Abstract

Background

The change impact of body composition during neoadjuvant therapy on clinical outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) remains unclear. The aim of this study was to investigate the association between changes in body composition during neoadjuvant chemoradiotherapy (NACRT) and postoperative outcomes in patients with PDAC undergoing pancreatectomy, using three-dimensional images.

Methods

We reviewed 66 consecutive patients with resectable/borderline resectable PDAC receiving gemcitabine and S-1 with radiotherapy between April 2010 and June 2016. Body compositions were evaluated pre- and post-NACRT. All patients were hospitalized and supplied with regulated diet during NACRT treatment.

Results

Psoas major muscle volume index (PMI), abdominal fat volume index, and visceral fat volume index decreased significantly after NACRT (P < 0.0001, P < 0.0001, P < 0.0001, respectively). The post-NACRT CA19-9 level decreased significantly in the small-PMI-decrease group compared with the large-PMI-decrease group (P = 0.046). Recurrence-free survival (RFS) and overall survival (OS) of the large-PMI-decrease group were significantly poorer than those of the small-PMI-decrease group (P = 0.002, P = 0.006, respectively). On the other hand, there were no significant differences in RFS and OS between groups with high and low PMI, at the point of either pre-NACRT (P = 0.117, P = 0.123, respectively) or post-NACRT (P = 0.065, P = 0.064, respectively). Multivariate analysis identified a large percentage decrease in PMI as an independent risk factor for recurrence and death (P = 0.003, P = 0.002, respectively).

Conclusions

Loss of skeletal muscle mass during NACRT was an independent risk factor for survival in patients with PDAC.
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Metadata
Title
Change Impact of Body Composition During Neoadjuvant Chemoradiotherapy in Patients with Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma Undergoing Pancreatectomy
Authors
Shohei Takaichi, MD, PhD
Yoshito Tomimaru, MD, PhD
Shogo Kobayashi, MD, PhD
Keisuke Toya, MD
Kazuki Sasaki, MD, PhD
Yoshifumi Iwagami, MD, PhD
Daisaku Yamada, MD, PhD
Takehiro Noda, MD, PhD
Hidenori Takahashi, MD, PhD
Tadafumi Asaoka, MD, PhD
Masahiro Tanemura, MD, PhD
Yuichiro Doki, MD, PhD
Hidetoshi Eguchi, MD, PhD
Publication date
27-12-2022
Publisher
Springer International Publishing
Keyword
Pancreatectomy
Published in
Annals of Surgical Oncology / Issue 4/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12985-0

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