Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Impact of sarcopenia on biliary drainage during neoadjuvant therapy for pancreatic cancer

  • Kunio Kataoka (Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine) ;
  • Eizaburo Ohno (Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine) ;
  • Takuya Ishikawa (Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine) ;
  • Kentaro Yamao (Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine) ;
  • Yasuyuki Mizutani (Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine) ;
  • Tadashi Iida (Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine) ;
  • Hideki Takami (Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine) ;
  • Osamu Maeda (Department of Clinical Oncology and Chemotherapy, Nagoya University Graduate School of Medicine ) ;
  • Junpei Yamaguchi (Department of Surgical Oncology, Nagoya University Graduate School of Medicine) ;
  • Yukihiro Yokoyama (Department of Surgical Oncology, Nagoya University Graduate School of Medicine) ;
  • Tomoki Ebata (Department of Surgical Oncology, Nagoya University Graduate School of Medicine) ;
  • Yasuhiro Kodera (Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine) ;
  • Hiroki Kawashima (Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine)
  • Received : 2022.10.31
  • Accepted : 2022.12.23
  • Published : 2024.01.30
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Abstract

Background/Aims: Since the usefulness of neoadjuvant chemo(radiation) therapy (NAT) for pancreatic cancer has been demonstrated, recurrent biliary obstruction (RBO) in patients with pancreatic cancer with a fully covered self-expandable metal stent (FCSEMS) during NAT is expected to increase. This study investigated the impact of sarcopenia on RBO in this setting. Methods: Patients were divided into normal and low skeletal muscle index (SMI) groups and retrospectively analyzed. Patient characteristics, overall survival, time to RBO (TRBO), stent-related adverse events, and postoperative complications were compared between the two groups. A Cox proportional hazard model was used to identify the risk factors for short TRBO. Results: A few significant differences were observed in patient characteristics, overall survival, stent-related adverse events, and postoperative complications between 38 patients in the normal SMI group and 17 in the low SMI group. The median TRBO was not reached in the normal SMI group and was 112 days in the low SMI group (p=0.004). In multivariate analysis, low SMI was the only risk factor for short TRBO, with a hazard ratio of 5.707 (95% confidence interval, 1.148-28.381; p=0.033). Conclusions: Sarcopenia was identified as an independent risk factor for RBO in patients with pancreatic cancer with FCSEMS during NAT.

Keywords

References

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