Body Composition and Response and Outcome of Neoadjuvant Treatment for Pancreatic Cancer

Abstract

To assess the correlation of body composition with the response and outcome of neoadjuvant treatment (NAT) in patients with pancreatic ductal adenocarcinoma (PDAC). One hundred and nineteen PDAC patients underwent curative resection after NAT. Computed tomography scans of the third lumbar vertebra were used to assess the body composition of these patients before and after NAT. Three distinct wasting phenotypes were identified during NAT, with 51 patients (42.9%) developing muscle and fat wasting (MFW), 17 patients (14.3%) developing fat-only wasting (FW), and 51 patients (42.9%) having no wasting (NW). The response rate was higher in the NW phenotype than in the MFW and FW phenotypes (P = 0.007). In univariate and multivariate analyses, histological grade, sarcopenia before NAT, and MFW during NAT were associated with decreased overall survival (OS). Sarcopenia before NAT and MFW during NAT were associated with decreased disease-free survival (DFS). Body composition was associated with the response and outcome of patients undergoing NAT for PDAC. The response rate was higher in patients having NW during NAT. Sarcopenia before NAT and MFW during NAT were associated with decreased OS and DFS.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics Approval and Consent to Participate

Institutional review board approval was obtained from the Shanghai Cancer Center.

Authors' contributions

Study concepts: Kaizhou Jin and Haiyang Zhou; Study design: Kaizhou Jin, Haiyang Zhou, and Xianjun Yu; Data acquisition: Kaizhou Jin and Yuan Tang; Quality control of data and algorithms: Kaizhou Jin and Anqi Wang; Data analysis and interpretation: Kaizhou Jin, Yuan Tang and Zhiqian Hu; Statistical analysis: Kaizhou Jin, Yuan Tang and Chen Liu; Manuscript preparation: Kaizhou Jin and Haiyang Zhou; Manuscript editing: Kaizhou Jin, Yuan Tang and Xianjun Yu; Manuscript review: All authors.

Additional information

Funding

This work was supported by the National Science Fund for Distinguished Young Scholars (No. 81625016, to Yu X), National Natural Science Foundation of China (No. 81571827, to Zhou H), Shanghai Rising-Star Program (No. 17QA1405600, to Zhou H), Shanghai Excellent Young Medical Talents Program (No. 2017YQ006, to Zhou H), Scientific Innovation Project of Shanghai Education Committee (2019-01-07-00-07-E00057, to Yu X) and Clinical and Scientific Innovation Project of Shanghai Hospital Development Center (SHDC12018109, to Yu X)