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- Title
Combination of sarcopenia and systemic inflammation-based markers for predicting the prognosis of patients undergoing pancreaticoduodenectomy for pancreatic cancer.
- Authors
Utsumi, Masashi; Inagaki, Masaru; Kitada, Koji; Tokunaga, Naoyuki; Yunoki, Kosuke; Okabayashi, Hiroki; Hamano, Ryosuke; Miyasou, Hideaki; Tsunemitsu, Yousuke; Otsuka, Shinya
- Abstract
Background: This study aimed to evaluate the effects of sarcopenia and inflammation on the prognosis of patients with pancreatic cancer after pancreaticoduodenectomy. Methods: Eighty patients who had undergone pancreaticoduodenectomy for pancreatic cancer between July 2010 and December 2023 were included in this study. The psoas muscle index was used to assess sarcopenia. The C-reactive protein-to-albumin ratio, prognostic nutritional index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were used to calculate the preoperative inflammatory marker levels. The prognostic factors for overall survival were determined using Cox regression analysis. Results: Twenty-four patients were diagnosed with sarcopenia. Sarcopenia showed a significant association with advanced tumor stage. Univariate analysis revealed a significant reduction in overall survival in patients with a prognostic nutritional index of <45, C-reactive protein-to-albumin ratio of ≥0.047, cancer antigen 19–9 levels of ≥130 U/mL, sarcopenia, lymph node metastasis, and vascular invasion. Multivariate analysis revealed that a C-reactive protein-to-albumin ratio of ≥0.047 (hazards ratio, 3.383; 95% confidence interval: 1.384–8.689; p< 0.001), cancer antigen 19–9 levels of ≥130 U/mL (hazards ratio, 2.720; 95% confidence interval: 1.291–6.060; p = 0.008), sarcopenia (hazards ratio, 3.256; 95% confidence interval: 1.535–7.072; p = 0.002) and vascular invasion (hazards ratio, 2.092; 95% confidence interval: 1.057–4.170; p = 0.034) were independent predictors of overall survival. Overall survival in the sarcopenia and high C-reactive protein-to-albumin ratio groups was significantly poorer than that in the non-sarcopenia and low C-reactive protein-to-albumin ratio and sarcopenia or high C-reactive protein-to-albumin ratio groups. Conclusion: Sarcopenia and a high C-reactive protein-to-albumin ratio are independent prognostic factors in patients with pancreatic cancer after pancreaticoduodenectomy. Thus, sarcopenia may have a better prognostic value when combined with the C-reactive protein-to-albumin ratio.
- Subjects
SARCOPENIA; PSOAS muscles; PANCREATIC cancer; PROGRESSION-free survival; PANCREATICODUODENECTOMY; CANCER prognosis; PLATELET lymphocyte ratio; PROGNOSIS
- Publication
PLoS ONE, 2024, Vol 19, Issue 6, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0305844