Evaluation of skeletal muscle mass and prognosis in patients with unresectable metastatic pancreatic cancer

Backgrounds Impact of sarcopenia in patients with advanced PC remains unclear. We examined whether skeletal muscle and the presence of sarcopenia are factors affecting overall survival (OS) in patients with unresectable PC. Methods Twenty-seven patients receiving first-line chemotherapy from January 2018 to August 2020 were retrospectively examined. The cross-sectional skeletal muscle area, and psoas muscle area at L3 were analyzed by computed tomography. Receiver operating characteristic curves were generated for psoas muscle mass index (PMI), skeletal muscle index (SMI) to elicit clinically relevant cut-offs. Sarcopenia was defined as an SMI of <42cm2/m2 (male) or an SMI of <38cm2/m2(female) according to the guidelines for the management of sarcopenia 2017. OS was compared according to sarcopenia, PMI, and SMI. Results Among the 27 patients reviewed, sarcopenia was diagnosed in 21 cases (77.8%), and there was no significant difference between men and women (p=0.385). The OS was 239.5 days in the normal and high PMI group (cut off value male 7.001, female 5.459) and109 days in the low PMI group, indicating prolonged survival in the former group (p=0.03). Conclusion PMI is a useful factor in patients with advanced metastatic PC. Subsequent studies with more patients are needed to confirm these data.