Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.15/2853 |
Resumo: | Cancer-associated-cachexia (CAC) is a ubiquitous characteristic of pancreatic cancer (PC) and 1/3 of patients die from its complications. Systemic inflammation is key in CAC and the modified Glasgow Prognostic Score (mGPS) is a reliable inflammation-based prognostic tool. We aimed to evaluate the prognostic value of consensus-based cachexia classification and mGPS, their agreement and to analyze relevant clinical predictors of cachexia. This unicentric, retrospective, cohort study included patients with advanced PC treated over a 5-year period. Cachexia was classified according to weight loss, body mass index and mGPS. Fisher’s test was used to test correlation between classifications and logistic regression models were performed to test their association with other variables. Survival was analyzed with cox regression and Kaplan-Meier curves. 88 eligible patients (mean age 72, 56% female) were reviewed. At baseline, cachectic patients (CP) (77%), when compared with pre-CP, had worse performance status (p=0.016), more NLR>3,5 (p<0.01) and hypoalbuminemia (p 0.01). Of 77% (n=68) categorized as cachectic, only 16% (n=8) had a positive mGPS. No association was found between classifications (p=0.187). In multivariate analysis, NLR>3.5 was a significant predictor of both cachexia (p<0.001) and positive mGPS (p<0.01). Median overall survival (OS) for pre-CP was 19.1 months vs. 4.9 months in the CP (HR 1.94 95% CI 1.10-3.43 p=0.02). A positive mGPS at baseline was an independent predictor of worst OS (HR 2.73, 95% CI 1.126.66, p=0.027). CAC leads to worst survival and a better understanding of this syndrome in PC may improve outcomes for these patients. Our study suggests a baseline predominant fat-only loss phenotype, that patients with positive mGPS are at higher risk of worst outcomes and that NLR is a potential predictor of CAC. A prompt identification of prognostic markers may lead to a better standardized management of CA. |
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Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome predictionCachexiaPancreatic cancerModified Glasgow prognostic scoreWright lossNeutrophil to lymphocyte ratioCancer-associated-cachexia (CAC) is a ubiquitous characteristic of pancreatic cancer (PC) and 1/3 of patients die from its complications. Systemic inflammation is key in CAC and the modified Glasgow Prognostic Score (mGPS) is a reliable inflammation-based prognostic tool. We aimed to evaluate the prognostic value of consensus-based cachexia classification and mGPS, their agreement and to analyze relevant clinical predictors of cachexia. This unicentric, retrospective, cohort study included patients with advanced PC treated over a 5-year period. Cachexia was classified according to weight loss, body mass index and mGPS. Fisher’s test was used to test correlation between classifications and logistic regression models were performed to test their association with other variables. Survival was analyzed with cox regression and Kaplan-Meier curves. 88 eligible patients (mean age 72, 56% female) were reviewed. At baseline, cachectic patients (CP) (77%), when compared with pre-CP, had worse performance status (p=0.016), more NLR>3,5 (p<0.01) and hypoalbuminemia (p 0.01). Of 77% (n=68) categorized as cachectic, only 16% (n=8) had a positive mGPS. No association was found between classifications (p=0.187). In multivariate analysis, NLR>3.5 was a significant predictor of both cachexia (p<0.001) and positive mGPS (p<0.01). Median overall survival (OS) for pre-CP was 19.1 months vs. 4.9 months in the CP (HR 1.94 95% CI 1.10-3.43 p=0.02). A positive mGPS at baseline was an independent predictor of worst OS (HR 2.73, 95% CI 1.126.66, p=0.027). CAC leads to worst survival and a better understanding of this syndrome in PC may improve outcomes for these patients. Our study suggests a baseline predominant fat-only loss phenotype, that patients with positive mGPS are at higher risk of worst outcomes and that NLR is a potential predictor of CAC. A prompt identification of prognostic markers may lead to a better standardized management of CA.SciTechnolRepositório Científico do Instituto Politécnico de SantarémCardoso, DeboraMatos, Leonor VasconcelosFernandes, LeonorDomingues, Tiago DiasSão João, RicardoMirra, Renata MedeirosMiranda, HelenaMartins, Ana2020-03-25T15:29:15Z2020-012020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.15/2853eng2324-9110info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-01-21T07:34:11Zoai:repositorio.ipsantarem.pt:10400.15/2853Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T01:54:45.366391Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction |
title |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction |
spellingShingle |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction Cardoso, Debora Cachexia Pancreatic cancer Modified Glasgow prognostic score Wright loss Neutrophil to lymphocyte ratio |
title_short |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction |
title_full |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction |
title_fullStr |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction |
title_full_unstemmed |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction |
title_sort |
Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction |
author |
Cardoso, Debora |
author_facet |
Cardoso, Debora Matos, Leonor Vasconcelos Fernandes, Leonor Domingues, Tiago Dias São João, Ricardo Mirra, Renata Medeiros Miranda, Helena Martins, Ana |
author_role |
author |
author2 |
Matos, Leonor Vasconcelos Fernandes, Leonor Domingues, Tiago Dias São João, Ricardo Mirra, Renata Medeiros Miranda, Helena Martins, Ana |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Instituto Politécnico de Santarém |
dc.contributor.author.fl_str_mv |
Cardoso, Debora Matos, Leonor Vasconcelos Fernandes, Leonor Domingues, Tiago Dias São João, Ricardo Mirra, Renata Medeiros Miranda, Helena Martins, Ana |
dc.subject.por.fl_str_mv |
Cachexia Pancreatic cancer Modified Glasgow prognostic score Wright loss Neutrophil to lymphocyte ratio |
topic |
Cachexia Pancreatic cancer Modified Glasgow prognostic score Wright loss Neutrophil to lymphocyte ratio |
description |
Cancer-associated-cachexia (CAC) is a ubiquitous characteristic of pancreatic cancer (PC) and 1/3 of patients die from its complications. Systemic inflammation is key in CAC and the modified Glasgow Prognostic Score (mGPS) is a reliable inflammation-based prognostic tool. We aimed to evaluate the prognostic value of consensus-based cachexia classification and mGPS, their agreement and to analyze relevant clinical predictors of cachexia. This unicentric, retrospective, cohort study included patients with advanced PC treated over a 5-year period. Cachexia was classified according to weight loss, body mass index and mGPS. Fisher’s test was used to test correlation between classifications and logistic regression models were performed to test their association with other variables. Survival was analyzed with cox regression and Kaplan-Meier curves. 88 eligible patients (mean age 72, 56% female) were reviewed. At baseline, cachectic patients (CP) (77%), when compared with pre-CP, had worse performance status (p=0.016), more NLR>3,5 (p<0.01) and hypoalbuminemia (p 0.01). Of 77% (n=68) categorized as cachectic, only 16% (n=8) had a positive mGPS. No association was found between classifications (p=0.187). In multivariate analysis, NLR>3.5 was a significant predictor of both cachexia (p<0.001) and positive mGPS (p<0.01). Median overall survival (OS) for pre-CP was 19.1 months vs. 4.9 months in the CP (HR 1.94 95% CI 1.10-3.43 p=0.02). A positive mGPS at baseline was an independent predictor of worst OS (HR 2.73, 95% CI 1.126.66, p=0.027). CAC leads to worst survival and a better understanding of this syndrome in PC may improve outcomes for these patients. Our study suggests a baseline predominant fat-only loss phenotype, that patients with positive mGPS are at higher risk of worst outcomes and that NLR is a potential predictor of CAC. A prompt identification of prognostic markers may lead to a better standardized management of CA. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-03-25T15:29:15Z 2020-01 2020-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.15/2853 |
url |
http://hdl.handle.net/10400.15/2853 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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2324-9110 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
SciTechnol |
publisher.none.fl_str_mv |
SciTechnol |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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