Decreased Skeletal Muscle Volume Is a Predictive Factor for Poorer Survival in Patients Undergoing Surgical Resection for Pancreatic Ductal Adenocarcinoma

Motokazu Sugimoto, Michael B. Farnell, David M. Nagorney, Michael L. Kendrick, Mark Truty, Rory L. Smoot, Suresh T Chari, Michael R. Moynagh, Gloria M Petersen, Rickey E. Carter, Naoki Takahashi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The aim of this study was to investigate the impact of decreased skeletal muscle (SM) volume on survival outcomes in patients undergoing surgical resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Between March 2000 and February 2015, 323 patients who underwent upfront surgical resection for PDAC were identified from the Mayo Clinic SPORE in Pancreatic Cancer. Body composition data, including SM area, subcutaneous adipose tissue area, and visceral adipose tissue area were calculated using an abdominal computed tomography (CT) image at the third lumbar spinal level. The body composition data were normalized by patients’ height (e.g., SM index, cm2/m2) and analyzed as continuous variables. Clinicopathological findings and body composition data at initial diagnosis were evaluated for association with overall survival and recurrence-free survival. Results: Because the median SM index was significantly different between males vs. females (49.9 cm2/m2 [range, 32.0–70.3] vs. 39.4 cm2/m2 [range, 29.2–66.2], P < 0.001), it was standardized for each sex and used for further analyses. Parameters independently associated with a shorter overall survival were a larger tumor size (P = 0.007), a greater tumor extent (P = 0.037), a higher carbohydrate antigen 19–9 level (P < 0.001), and a smaller sex-standardized SM index (P = 0.011). Parameters independently associated with a shorter recurrence-free survival were female sex (P = 0.029), a larger tumor size (P < 0.001), a higher carbohydrate antigen 19–9 level (P = 0.001), and a smaller sex-standardized SM index (P = 0.007). Conclusions: A smaller sex-standardized SM index is a predictive factor for shorter overall and recurrence-free survival in PDAC patients undergoing surgery.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Feb 1 2018

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Skeletal Muscle
Adenocarcinoma
Survival
Body Composition
Recurrence
Carbohydrates
Antigens
Neoplasms
Intra-Abdominal Fat
Subcutaneous Fat
Pancreatic Neoplasms
Tomography

Keywords

  • Pancreatectomy
  • Pancreatic ductal adenocarcinoma
  • Sarcopenia
  • Skeletal muscle
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Decreased Skeletal Muscle Volume Is a Predictive Factor for Poorer Survival in Patients Undergoing Surgical Resection for Pancreatic Ductal Adenocarcinoma. / Sugimoto, Motokazu; Farnell, Michael B.; Nagorney, David M.; Kendrick, Michael L.; Truty, Mark; Smoot, Rory L.; Chari, Suresh T; Moynagh, Michael R.; Petersen, Gloria M; Carter, Rickey E.; Takahashi, Naoki.

In: Journal of Gastrointestinal Surgery, 01.02.2018, p. 1-9.

Research output: Contribution to journalArticle

Sugimoto, Motokazu ; Farnell, Michael B. ; Nagorney, David M. ; Kendrick, Michael L. ; Truty, Mark ; Smoot, Rory L. ; Chari, Suresh T ; Moynagh, Michael R. ; Petersen, Gloria M ; Carter, Rickey E. ; Takahashi, Naoki. / Decreased Skeletal Muscle Volume Is a Predictive Factor for Poorer Survival in Patients Undergoing Surgical Resection for Pancreatic Ductal Adenocarcinoma. In: Journal of Gastrointestinal Surgery. 2018 ; pp. 1-9.
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abstract = "Background: The aim of this study was to investigate the impact of decreased skeletal muscle (SM) volume on survival outcomes in patients undergoing surgical resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Between March 2000 and February 2015, 323 patients who underwent upfront surgical resection for PDAC were identified from the Mayo Clinic SPORE in Pancreatic Cancer. Body composition data, including SM area, subcutaneous adipose tissue area, and visceral adipose tissue area were calculated using an abdominal computed tomography (CT) image at the third lumbar spinal level. The body composition data were normalized by patients’ height (e.g., SM index, cm2/m2) and analyzed as continuous variables. Clinicopathological findings and body composition data at initial diagnosis were evaluated for association with overall survival and recurrence-free survival. Results: Because the median SM index was significantly different between males vs. females (49.9 cm2/m2 [range, 32.0–70.3] vs. 39.4 cm2/m2 [range, 29.2–66.2], P < 0.001), it was standardized for each sex and used for further analyses. Parameters independently associated with a shorter overall survival were a larger tumor size (P = 0.007), a greater tumor extent (P = 0.037), a higher carbohydrate antigen 19–9 level (P < 0.001), and a smaller sex-standardized SM index (P = 0.011). Parameters independently associated with a shorter recurrence-free survival were female sex (P = 0.029), a larger tumor size (P < 0.001), a higher carbohydrate antigen 19–9 level (P = 0.001), and a smaller sex-standardized SM index (P = 0.007). Conclusions: A smaller sex-standardized SM index is a predictive factor for shorter overall and recurrence-free survival in PDAC patients undergoing surgery.",
keywords = "Pancreatectomy, Pancreatic ductal adenocarcinoma, Sarcopenia, Skeletal muscle, Survival",
author = "Motokazu Sugimoto and Farnell, {Michael B.} and Nagorney, {David M.} and Kendrick, {Michael L.} and Mark Truty and Smoot, {Rory L.} and Chari, {Suresh T} and Moynagh, {Michael R.} and Petersen, {Gloria M} and Carter, {Rickey E.} and Naoki Takahashi",
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T1 - Decreased Skeletal Muscle Volume Is a Predictive Factor for Poorer Survival in Patients Undergoing Surgical Resection for Pancreatic Ductal Adenocarcinoma

AU - Sugimoto, Motokazu

AU - Farnell, Michael B.

AU - Nagorney, David M.

AU - Kendrick, Michael L.

AU - Truty, Mark

AU - Smoot, Rory L.

AU - Chari, Suresh T

AU - Moynagh, Michael R.

AU - Petersen, Gloria M

AU - Carter, Rickey E.

AU - Takahashi, Naoki

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: The aim of this study was to investigate the impact of decreased skeletal muscle (SM) volume on survival outcomes in patients undergoing surgical resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Between March 2000 and February 2015, 323 patients who underwent upfront surgical resection for PDAC were identified from the Mayo Clinic SPORE in Pancreatic Cancer. Body composition data, including SM area, subcutaneous adipose tissue area, and visceral adipose tissue area were calculated using an abdominal computed tomography (CT) image at the third lumbar spinal level. The body composition data were normalized by patients’ height (e.g., SM index, cm2/m2) and analyzed as continuous variables. Clinicopathological findings and body composition data at initial diagnosis were evaluated for association with overall survival and recurrence-free survival. Results: Because the median SM index was significantly different between males vs. females (49.9 cm2/m2 [range, 32.0–70.3] vs. 39.4 cm2/m2 [range, 29.2–66.2], P < 0.001), it was standardized for each sex and used for further analyses. Parameters independently associated with a shorter overall survival were a larger tumor size (P = 0.007), a greater tumor extent (P = 0.037), a higher carbohydrate antigen 19–9 level (P < 0.001), and a smaller sex-standardized SM index (P = 0.011). Parameters independently associated with a shorter recurrence-free survival were female sex (P = 0.029), a larger tumor size (P < 0.001), a higher carbohydrate antigen 19–9 level (P = 0.001), and a smaller sex-standardized SM index (P = 0.007). Conclusions: A smaller sex-standardized SM index is a predictive factor for shorter overall and recurrence-free survival in PDAC patients undergoing surgery.

AB - Background: The aim of this study was to investigate the impact of decreased skeletal muscle (SM) volume on survival outcomes in patients undergoing surgical resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Between March 2000 and February 2015, 323 patients who underwent upfront surgical resection for PDAC were identified from the Mayo Clinic SPORE in Pancreatic Cancer. Body composition data, including SM area, subcutaneous adipose tissue area, and visceral adipose tissue area were calculated using an abdominal computed tomography (CT) image at the third lumbar spinal level. The body composition data were normalized by patients’ height (e.g., SM index, cm2/m2) and analyzed as continuous variables. Clinicopathological findings and body composition data at initial diagnosis were evaluated for association with overall survival and recurrence-free survival. Results: Because the median SM index was significantly different between males vs. females (49.9 cm2/m2 [range, 32.0–70.3] vs. 39.4 cm2/m2 [range, 29.2–66.2], P < 0.001), it was standardized for each sex and used for further analyses. Parameters independently associated with a shorter overall survival were a larger tumor size (P = 0.007), a greater tumor extent (P = 0.037), a higher carbohydrate antigen 19–9 level (P < 0.001), and a smaller sex-standardized SM index (P = 0.011). Parameters independently associated with a shorter recurrence-free survival were female sex (P = 0.029), a larger tumor size (P < 0.001), a higher carbohydrate antigen 19–9 level (P = 0.001), and a smaller sex-standardized SM index (P = 0.007). Conclusions: A smaller sex-standardized SM index is a predictive factor for shorter overall and recurrence-free survival in PDAC patients undergoing surgery.

KW - Pancreatectomy

KW - Pancreatic ductal adenocarcinoma

KW - Sarcopenia

KW - Skeletal muscle

KW - Survival

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