Sarcopenia as an independent prognostic factor of reduced survival in elderly pancreatic cancer patients: A single-center experience
Keywords:
Sarcopenia; pancreatic cancer; elderly; prognosis; survival; nutritional support.Abstract
Introduction
Sarcopenia, characterized by a loss of muscle mass and function, is highly prevalent in elderly patients with pancreatic cancer, often associated with cachexia. It significantly impacts prognosis by influencing therapeutic tolerance and survival. This study aimed to evaluate the prevalence and clinical impact of sarcopenia in elderly patients with pancreatic cancer.
Methods
We conducted a retrospective, single-center study of 30 patients with pancreatic cancer. Demographic, clinical, genetic, therapeutic, and outcome data were collected and analyzed using a standardized grid. Each case was discussed in a multidisciplinary team (MDT) meeting. Statistical analysis assessed the association between sarcopenia and prognosis.
Results
The mean age at diagnosis was 69.4 years (range: 46–90). Comorbidities included diabetes (43.3%), arterial hypertension (33.3%), and familial cancer history (33.3%). Tumor location was cephalic in 93% of cases. Disease stages were: localized (23%), locally advanced (43.3%), and metastatic (33.3%). Clinically, asthenia and abdominal pain were present in 50% of cases, jaundice in 66.6%. WHO performance status was 1 in 23.3% and 2 in 76.7%. Severe weight loss (>10 kg) occurred in 66.6% of patients. Sarcopenia was present in 60% of cases. Treatments included FOLFIRINOX (33.3%), gemcitabine-platinum salts (33.3%), gemcitabine-nimotuzumab (16.6%), and gemcitabine alone (16.6%). Median overall survival was 8 months, significantly lower in sarcopenic patients (6 vs. 11 months; p < 0.05).
Discussion
Our results confirm the high prevalence of sarcopenia in elderly pancreatic cancer patients. Sarcopenia is associated with impaired general condition, significant weight loss, and reduced survival. It serves as a marker of frailty and an independent unfavorable prognostic factor.
Conclusion
Sarcopenia is common in elderly pancreatic cancer patients and linked to poor prognosis. Systematic screening is essential to optimize therapeutic management. A multidisciplinary approach integrating nutritional support and physical activity is vital for improving outcomes.
References
1. Rahib L, Smith BD, Aizenman L, et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014;74(11):2913–2921.
2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30.
3. Muscaritoli M, Anker SD, Argilés J, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) of the ESPEN. Clin Nutr. 2010;29(2):154–159.
4. Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489–495.
5. Prado CM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629–635.
6. Antoun S, Birdsell L, Sawyer MB, et al. Low muscle mass and sarcopenia associated with toxicities in cancer patients. Support Care Cancer. 2013;21(11):3259–3266.
7. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
8. Voron T, Tselikas L, Pietri S, et al. Sarcopenia impacts on survival of patients with pancreatic adenocarcinoma. J Surg Oncol. 2015;111(6):771–775.
9. Martin L, Birdsell L, Macdonald N, et al. Cancer cachexia in the era of targeted therapy: phenotypes, terminology, and definitions. J Cachexia Sarcopenia Muscle. 2013;4(1):1–4.
10. Prado CM, Baracos VE, McCargar LJ, et al. Body composition as an independent determinant of 5-year survival after conventional chemotherapy for metastatic breast cancer. J Clin Oncol. 2008;26(20):5034–5039.
11. Fearon KC, Glass DJ, Guttridge DC. Cancer cachexia: mediators, signaling, and metabolic pathways. Cell Metab. 2012;16(2):153–166.
12. Cesari M, Leeuwenburgh C, Lauretani F, et al. Frailty syndrome and sarcopenia in later years: an update. Ageing Res Rev. 2008;7(1):43–48.
13. Bozzetti F, Arends J, Lundholm K, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2006;25(2):185–200.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Author(s)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Articles published in the Journal of Advanced Multidisciplinary Studies (JAMS) are licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0), unless otherwise stated. Authors retain copyright of their work and grant JAMS the right of first publication.
