Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Nutr Cancer. 2013;65(6):827-33. doi: 10.1080/01635581.2013.804580.
Chronic pancreatitis (CP) and pancreatic adenocarcinoma (PDAC) are the most common diseases of the pancreas. Cachexia-weight loss exceeding 10% of stable body weight-is present in up to 80% of patients with PDAC. Because the mechanisms of cachexia are not well known, this provides a possibility to compare clinical courses of benign and malignant cachexia. In this study, 382 patients-242 with a PDAC stage UICC II/ 140 with CP-were documented regarding the prevalence of cachexia and its influence on perioperative morbidity and mortality with a special interest to postoperative weight gain and survival. Cachexia was present in 41.4% of CP and 31% of cancer patients. We could demonstrate more pronounced systemic effects of cachexia in patients with PDAC. Weight loss was faster in PDAC patients, the amount of weight loss did not differ significantly between the groups. Cachexia had a significant impact on survival and the postoperative course in patients with PDAC and tumor resection. The development of cachexia is faster in patients with a malignant disease and the systemic effects are more pronounced. Therefore, tumor cachexia should be considered as a different entity than cachexia in benign diseases.
慢性胰腺炎 (CP) 和胰腺腺癌 (PDAC) 是最常见的胰腺疾病。体重减轻超过稳定体重的 10%，即恶病质，在多达 80%的 PDAC 患者中存在。由于恶病质的机制尚不清楚，这为比较良性和恶性恶病质的临床病程提供了可能性。在这项研究中，我们记录了 382 名患者的资料，其中 242 名患有 PDAC 分期 UICC II/140 名患有 CP，评估恶病质的流行情况及其对围手术期发病率和死亡率的影响，特别关注术后体重增加和生存情况。CP 患者中恶病质的发生率为 41.4%，癌症患者为 31%。我们可以证明 PDAC 患者中恶病质的全身影响更为明显。PDAC 患者的体重下降更快，两组之间的体重下降量没有显著差异。恶病质对 PDAC 患者的生存和术后病程有显著影响，并进行了肿瘤切除术。恶性疾病患者恶病质的发展更快，全身影响更为明显。因此，肿瘤恶病质应被视为与良性疾病中恶病质不同的实体。
