Longitudinal Changes in Inflammatory and Nutritional Status Are Associated With Survival in Advanced Pancreatic Cancer
Kohei Nagata, Ichiro Yasuda, Yuko Ueda, Hiroki Kawanaka, Jun Sakamoto, Banri Ogino, Toshiki Entani, Iori Motoo, Nobuhiko Hayashi, Ando Takayuki, Shinya Kajiura, Kazuto TajiriBackground:
Systemic inflammation and nutritional deterioration are common in advanced pancreatic cancer (APC); however, the prognostic significance of their longitudinal changes remains unclear.
Objectives:
To evaluate whether longitudinal changes in inflammatory and nutritional measures are associated with survival.
Methods:
We retrospectively analyzed 120 patients with unresectable APC who reached third-line treatment or best supportive care after second-line chemotherapy. Changes in the C-reactive protein-to-albumin ratio (ΔCAR) and body weight were evaluated.
Results:
High ΔCAR and body weight loss were associated with shorter overall survival. Patients with both high ΔCAR and body weight loss had the poorest survival; those with neither had the longest survival (1.38 vs. 4.67 months). Eastern Cooperative Oncology Group (ECOG) performance status (PS), ΔCAR, and body weight loss were independent prognostic factors. ΔCAR and weight loss were associated with appetite loss and worsening PS.
Conclusions:
Longitudinal deterioration in inflammatory and nutritional measures was associated with poor survival and clinical decline in APC.