Body composition measurements and clinical outcomes in patients with resectable pancreatic adenocarcinoma - analysis from SWOG S1505.

Body composition Measurements Pancreatic adenocarcinoma

Journal

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: United States
ID NLM: 9706084

Informations de publication

Date de publication:
Mar 2024
Historique:
received: 09 10 2023
revised: 08 12 2023
accepted: 16 12 2023
medline: 6 3 2024
pubmed: 6 3 2024
entrez: 6 3 2024
Statut: ppublish

Résumé

Sarcopenic obesity and muscle attenuation have been associated with survival in patients with borderline resectable and advanced pancreatic ductal adenocarcinoma (PDA); however, these relationships are unknown for patients with resectable PDA. This study examined the associations between skeletal muscle and adipose tissue as measured on baseline computed tomography (CT) and the overall survival (OS) of participants with resectable PDA in a secondary analysis of the Southwest Oncology Group S1505 clinical trial (identifier: NCT02562716). The S1505 phase II clinical trial enrolled patients with resectable PDA who were randomized to receive modified FOLFIRINOX or gemcitabine and nab-paclitaxel as perioperative chemotherapy, followed by surgical resection. Baseline axial CT images at the L3 level were analyzed with externally validated software, and measurements were recorded for skeletal muscle area and skeletal muscle density, visceral adipose tissue area (VATA) and density, and subcutaneous adipose tissue area and density. The relationships between CT metrics and OS were analyzed using Cox regression models, with adjustment for baseline participant characteristics. Of 98 eligible participants with available baseline abdominal CT, 8 were excluded because of imaging quality (eg, orthopedic hardware), resulting in 90 evaluable cases: 51 men (57.0%; mean age, 63.2 years [SD, 8.5]; mean body mass index [BMI], 29.3 kg/m This was the first study to systematically evaluate body composition parameters in a prospective multicenter trial of patients with resectable PDA who received perioperative chemotherapy. Visceral adipose tissue was associated with survival; however, there was no association between OS and sarcopenia or sarcopenic obesity. Further studies should evaluate these findings in more detail.

Sections du résumé

BACKGROUND BACKGROUND
Sarcopenic obesity and muscle attenuation have been associated with survival in patients with borderline resectable and advanced pancreatic ductal adenocarcinoma (PDA); however, these relationships are unknown for patients with resectable PDA. This study examined the associations between skeletal muscle and adipose tissue as measured on baseline computed tomography (CT) and the overall survival (OS) of participants with resectable PDA in a secondary analysis of the Southwest Oncology Group S1505 clinical trial (identifier: NCT02562716).
METHODS METHODS
The S1505 phase II clinical trial enrolled patients with resectable PDA who were randomized to receive modified FOLFIRINOX or gemcitabine and nab-paclitaxel as perioperative chemotherapy, followed by surgical resection. Baseline axial CT images at the L3 level were analyzed with externally validated software, and measurements were recorded for skeletal muscle area and skeletal muscle density, visceral adipose tissue area (VATA) and density, and subcutaneous adipose tissue area and density. The relationships between CT metrics and OS were analyzed using Cox regression models, with adjustment for baseline participant characteristics.
RESULTS RESULTS
Of 98 eligible participants with available baseline abdominal CT, 8 were excluded because of imaging quality (eg, orthopedic hardware), resulting in 90 evaluable cases: 51 men (57.0%; mean age, 63.2 years [SD, 8.5]; mean body mass index [BMI], 29.3 kg/m
CONCLUSION CONCLUSIONS
This was the first study to systematically evaluate body composition parameters in a prospective multicenter trial of patients with resectable PDA who received perioperative chemotherapy. Visceral adipose tissue was associated with survival; however, there was no association between OS and sarcopenia or sarcopenic obesity. Further studies should evaluate these findings in more detail.

Identifiants

pubmed: 38445914
pii: S1091-255X(23)07794-6
doi: 10.1016/j.gassur.2023.12.022
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02562716']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

232-235

Informations de copyright

Copyright © 2023. Published by Elsevier Inc.

Auteurs

Davendra P S Sohal (DPS)

University of Cincinnati, Cincinnati, Ohio, United States. Electronic address: sohalda@uc.edu.

Robert D Boutin (RD)

Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington State, United States.

Leon Lenchik (L)

Stanford University, Stanford, California, United States.

Jiyoon Kim (J)

Wake Forest University, Winston-Salem, North Carolina, United States.

M Shaalan Beg (MS)

University of Texas Southwestern Medical Center, Dallas, Texas, United States.

Andrea Wang-Gillam (A)

Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States.

James Lloyd Wade (JL)

Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Decatur, Illinois, United States.

Katherine A Guthrie (KA)

Southwest Oncology Group Statistics and Data Management Center, Seattle, Washington State, United States.

E Gabriela Chiorean (EG)

University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington State, United States.

Syed A Ahmad (SA)

University of Cincinnati, Cincinnati, Ohio, United States.

Andrew M Lowy (AM)

University of California San Diego Moores Cancer Center, La Jolla, California, United States.

Philip Agop Philip (PA)

Karmanos Cancer Institute, Detroit, Michigan, United States.

Victor Tsu-Shih Chang (VT)

Section of Hematology/Oncology, Veterans Administration New Jersey Health Care System, East Orange, New Jersey, United States.

Classifications MeSH