Sarcopenia represents a negative prognostic factor in pancreatic cancer patients undergoing EUS celiac plexus neurolysis.
EUS
celiac plexus neurolysis
pain
tumor
Journal
Endoscopic ultrasound
ISSN: 2303-9027
Titre abrégé: Endosc Ultrasound
Pays: China
ID NLM: 101622292
Informations de publication
Date de publication:
Historique:
pubmed:
3
7
2020
medline:
3
7
2020
entrez:
3
7
2020
Statut:
ppublish
Résumé
Increasing evidence suggests a prognostic role of sarcopenia in pancreatic cancer patients. The aim of this study was to assess the influence of sarcopenia on treatment outcomes after EUS-guided celiac plexus neurolysis (CPN). Data regarding 215 patients treated with EUS CPN between 2004 and 2019 were reviewed. Determination of body composition was conducted on contrast-enhanced CT scan, and pain response was considered as the primary outcome. Univariate and multivariate logistic regression was performed to identify the independent predictors of pain response. Treatment was successful in 187 patients (86.9%). The median age was 62 (range 39-84) years, and most patients were male (61.8%). Of the whole study population, 139 patients (64.6%) were defined as sarcopenic, of which 116 (83.4%) responded to the treatment and 5 (3.5%) experienced a complete response. Among 76 nonsarcopenic participants, 71 (93.4%) responded to the treatment and 22 (28.9%) obtained a complete response (P = 0.03 and <0.001, respectively). The median duration of pain relief was 8 (2-10) and 15 (8-16) weeks in sarcopenic and nonsarcopenic patients, respectively (P = 0.01). The median overall survival after neurolysis was 4 months (3-5) in sarcopenic participants and 7 months (6-8) in nonsarcopenic participants (P = 0.05). Tumoral stage, interval from the diagnosis to treatment, and sarcopenia resulted as significant prognostic factors for treatment response both in univariate and multivariate regression analyses. No severe treatment-related adverse events were reported in the whole study population, with no difference between the two groups. Sarcopenia represents a predictor of poorer response to EUS CPN.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Increasing evidence suggests a prognostic role of sarcopenia in pancreatic cancer patients. The aim of this study was to assess the influence of sarcopenia on treatment outcomes after EUS-guided celiac plexus neurolysis (CPN).
MATERIALS AND METHODS
METHODS
Data regarding 215 patients treated with EUS CPN between 2004 and 2019 were reviewed. Determination of body composition was conducted on contrast-enhanced CT scan, and pain response was considered as the primary outcome. Univariate and multivariate logistic regression was performed to identify the independent predictors of pain response.
RESULTS
RESULTS
Treatment was successful in 187 patients (86.9%). The median age was 62 (range 39-84) years, and most patients were male (61.8%). Of the whole study population, 139 patients (64.6%) were defined as sarcopenic, of which 116 (83.4%) responded to the treatment and 5 (3.5%) experienced a complete response. Among 76 nonsarcopenic participants, 71 (93.4%) responded to the treatment and 22 (28.9%) obtained a complete response (P = 0.03 and <0.001, respectively). The median duration of pain relief was 8 (2-10) and 15 (8-16) weeks in sarcopenic and nonsarcopenic patients, respectively (P = 0.01). The median overall survival after neurolysis was 4 months (3-5) in sarcopenic participants and 7 months (6-8) in nonsarcopenic participants (P = 0.05). Tumoral stage, interval from the diagnosis to treatment, and sarcopenia resulted as significant prognostic factors for treatment response both in univariate and multivariate regression analyses. No severe treatment-related adverse events were reported in the whole study population, with no difference between the two groups.
CONCLUSIONS
CONCLUSIONS
Sarcopenia represents a predictor of poorer response to EUS CPN.
Identifiants
pubmed: 32611849
pii: 288817
doi: 10.4103/eus.eus_24_20
pmc: PMC7529006
doi:
Types de publication
Journal Article
Langues
eng
Pagination
238-244Déclaration de conflit d'intérêts
None
Références
N Engl J Med. 2014 Sep 11;371(11):1039-49
pubmed: 25207767
Endosc Ultrasound. 2017 Nov-Dec;6(6):369-375
pubmed: 29251270
J Gastroenterol Hepatol. 2017 Feb;32(2):439-445
pubmed: 27356212
Trends Endocrinol Metab. 2013 Apr;24(4):174-83
pubmed: 23201432
Appl Physiol Nutr Metab. 2008 Oct;33(5):997-1006
pubmed: 18923576
J Clin Oncol. 2011 Sep 10;29(26):3541-6
pubmed: 21844506
Gastrointest Endosc. 2011 Dec;74(6):1300-7
pubmed: 22000795
Gastrointest Endosc. 1996 Dec;44(6):656-62
pubmed: 8979053
Dig Endosc. 2017 May;29(4):455-462
pubmed: 28160344
Cancers (Basel). 2019 Nov 25;11(12):
pubmed: 31769421
PLoS One. 2019 May 6;14(5):e0215915
pubmed: 31059520
Cancer Control. 2000 Mar-Apr;7(2):111-9
pubmed: 10783815
J Clin Med. 2018 Dec 01;7(12):
pubmed: 30513776
Endosc Ultrasound. 2015 Oct-Dec;4(4):342-4
pubmed: 26643704
J Gastrointest Oncol. 2018 Feb;9(1):24-34
pubmed: 29564168
Pancreatology. 2019 Sep;19(6):866-872
pubmed: 31375433
Nat Rev Cancer. 2014 Nov;14(11):754-62
pubmed: 25291291
Psychol Med. 1988 Nov;18(4):1007-19
pubmed: 3078045
Lancet Oncol. 2008 Jul;9(7):629-35
pubmed: 18539529
Pancreatology. 2019 Jan;19(1):127-135
pubmed: 30473464
PLoS One. 2018 May 3;13(5):e0196235
pubmed: 29723245
Endosc Ultrasound. 2014 Oct;3(4):213-20
pubmed: 25485268
Curr Treat Options Gastroenterol. 2018 Dec;16(4):417-427
pubmed: 30209676