Show simple item record

dc.contributor.authorCarnie, Lyndsay
dc.contributor.authorAbraham, Marc
dc.contributor.authorMcNamara, Mairead G
dc.contributor.authorHubner, Richard A
dc.contributor.authorValle, Juan W
dc.contributor.authorLamarca, Angela
dc.date.accessioned2020-11-16T07:49:05Z
dc.date.available2020-11-16T07:49:05Z
dc.date.issued2020en
dc.identifier.citationCarnie L, Abraham M, McNamara MG, Hubner RA, Valle JW, Lamarca A. Impact on prognosis of early weight loss during palliative chemotherapy in patients diagnosed with advanced pancreatic cancer. Pancreatology. 2020.en
dc.identifier.pmid33046391en
dc.identifier.doi10.1016/j.pan.2020.09.012en
dc.identifier.urihttp://hdl.handle.net/10541/623360
dc.description.abstractAim: Weight loss at diagnosis is common in pancreatic cancer (PC) and can adversely affect overall survival (OS). Little is known about the impact of weight loss occurring during palliative treatment. This study aimed to investigate if early weight loss during chemotherapy for inoperable PC affects OS. Method: This retrospective study included patients newly-diagnosed with inoperable PC. Consecutive patients initiating first-line palliative chemotherapy between Jan'15 - Jan'19 with data on percentage weight loss at week 4 of treatment (%WLWeek4) were eligible. %WLWeek4 was dichotomised using 5% cut-off. OS was measured from chemotherapy initiation. Survival analysis was performed using Cox regression. Results: Eligible patients (n = 255); 59.2% with head/neck PC; 52.6% metastatic; received triplet (32.2%), doublet (42.7%) or single-agent (25.1%) palliative chemotherapy. Median %WLWeek4 was -2.05% (95% confidence interval (CI) -2.58 to -1.56); %WLWeek4 was ?5% in 23.1% patients. Patients on triplet chemotherapy were more likely to develop %WLWeek4 of ?5% [35.4% (triplet) vs. 19.3% (doublet) vs 14.1% (monotherapy); multivariable Odds Ratio (triplet vs monotherapy) =3.25; 95% CI 1.40-7.56; p-value 0.006]. Median OS was 9.7 months (95% CI 8.54-10.41). Multivariable Cox regression demonstrated shorter OS if %WLWeek4 ?5% (median OS 7.4 months (95% CI 6.27-10.01) vs. 9.9 months (95% CI 9.20-12.05); HR 2.37 (95% CI 1.64-3.42), P < 0.001); this was independent from other factors (stage, age, number of chemotherapy drugs, ECOG-PS), including response to therapy (supporting that %WLWeek4 impacted on OS regardless of response to therapy). Conclusion: In advanced PC treated with palliative chemotherapy, a %WLWeek4 ?5% was more prevalent in patients undergoing triplet chemotherapy, and was associated with shorter OS, regardless of response/progression to therapy. Early identification and intervention of weight loss seems to be key to improve patient outcomes.en
dc.language.isoenen
dc.relation.urlhttps://dx.doi.org/10.1016/j.pan.2020.09.012en
dc.titleImpact on prognosis of early weight loss during palliative chemotherapy in patients diagnosed with advanced pancreatic canceren
dc.typeArticleen
dc.contributor.departmentNutrition & Dietetics, The Christie NHS Foundation Trust, Manchester, UK.en
dc.identifier.journalPancreatologyen
dc.description.noteen]


Files in this item

This item appears in the following Collection(s)

Show simple item record