Pancreas. 2024 May 1;53(5):e405-e409. doi: 10.1097/MPA.0000000000002319. Epub 2024 Mar 21.
Pancreatic ductal adenocarcinoma (PDAC) is a common cancer with a poor prognosis and is associated with a high prevalence of cachexia, a metabolic syndrome of muscle wasting due to complex mechanisms. In addition to loss of muscle mass, cancer patients also experience functional deterioration. The aim of this study is to determine whether there is an association between muscle mass and function and clinical outcomes, particularly survival.
We performed a prospective cohort study including all patients with PDAC at Monash Health from March 2016 to December 2017. We conducted body composition analysis for myopenia and handgrip strength testing. We constructed Kaplan-Meier curves to estimate whether myopenia and low hand grip strength were associated with poorer survival.
Myopenia was not associated with a significant difference in PDAC-specific survival (log-rank P = 0.60). However, low handgrip strength was associated with significantly worse PDAC-specific survival compared with other patients (log-rank hazard ratio, 1.88; 95% confidence interval, 1.15-3.09; P = 0.004).
The relationship between survival in PDAC and handgrip strength, but not anatomical muscle mass, suggests that functional testing of strength may be important in prognostication of patients with PDAC, alongside existing tools such as the Eastern Cooperative Oncology Group performance status.
胰腺导管腺癌 (PDAC) 是一种常见的癌症，预后较差，常伴有恶病质，这是一种由于复杂机制导致的肌肉消耗代谢综合征。除了肌肉质量的丧失外，癌症患者还经历功能恶化。本研究旨在确定肌肉质量和功能与临床结果（尤其是生存）之间是否存在关联。
我们进行了一项前瞻性队列研究，纳入了 2016 年 3 月至 2017 年 12 月期间在莫纳什健康医院就诊的所有 PDAC 患者。我们对肌肉减少症和握力进行了身体成分分析。我们构建了 Kaplan-Meier 曲线来评估肌肉减少症和低握力是否与较差的生存相关。
肌肉减少症与 PDAC 特异性生存无显著差异（对数秩检验 P = 0.60）。然而，与其他患者相比，低握力与 PDAC 特异性生存显著相关（对数秩风险比，1.88；95%置信区间，1.15-3.09；P = 0.004）。
PDAC 患者的生存与握力相关，而与解剖学肌肉质量无关，这表明力量的功能测试可能与现有的东部合作肿瘤学组表现状态等工具一起，对 PDAC 患者的预后具有重要意义。
