Impact of zinc deficiency on the prognosis of unresectable pancreatic cancer.

BACKGROUND/OBJECTIVES: Pancreatic cancer (PC) is an aggressive malignancy with a poor prognosis. Zinc deficiency (ZD) is prevalent among patients with cancer, especially those with PC, owing to factors such as malabsorption and systemic inflammation. Although ZD is associated with poor nutritional status and cancer cachexia, its impact on overall survival (OS) in unresectable PCs remains unclear. This study aimed to evaluate the prevalence of ZD in patients with unresectable PC and its influence on prognosis.

METHODS

A retrospective study was conducted on 272 patients with unresectable pancreatic cancer whose serum zinc levels measured before starting chemotherapy between April 2016 and March 2024. ZD was defined as serum zinc level below 60 μg/dL. Patient characteristics, nutritional indices (modified Glasgow prognostic score [mGPS], neutrophil-to-lymphocyte ratio [NLR], prognostic nutritional index [PNI], controlling nutritional status [CONUT] score), and survival outcomes were analyzed.

RESULTS

ZD was identified in 19.4 % of patients. Patients with ZD were significantly older and exhibited lower PNI, indicating poorer nutritional status. Regarding OS, univariate analysis showed that the ZD group had significantly lower survival rates than non-ZD group. Multivariate analysis revealed that ZD was an independent predictor of poor prognosis.

CONCLUSIONS

This study demonstrates that ZD before chemotherapy is an independent prognostic factor in patients with unresectable PC undergoing chemotherapy. Considering its association with poor nutritional status, serum zinc levels may serve as a valuable prognostic biomarker. Further research is warranted to explore the potential therapeutic benefits of zinc supplementation therapy.