CT-based screening of sarcopenia and its role in cachexia syndrome in pancreatic cancer

Since computed tomography (CT) is a part of standard diagnostic protocol in pancreatic ductal adenocarcinoma (PDAC), we have evaluated the value of CT for sarcopenia screening in patients with PDAC, intending to expand the diagnostic value of tomographic studies. In our study, we included 177 patien...

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Main Authors: Khristenko, Ekaterina (Author) , Sinitsyn, Valentin (Author) , Rieden, Tatiana (Author) , Girod, Parker (Author) , Kauczor, Hans-Ulrich (Author) , Mayer, Philipp (Author) , Klauß, Miriam (Author) , Lyadov, Vladimir (Author)
Format: Article (Journal)
Language:English
Published: January 25, 2024
In: PLOS ONE
Year: 2024, Volume: 19, Issue: 1, Pages: 1-12
ISSN:1932-6203
DOI:10.1371/journal.pone.0291185
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1371/journal.pone.0291185
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Author Notes:Ekaterina Khristenko, Valentin Sinitsyn, Tatiana Rieden, Parker Girod, Hans-Ulrich Kauczor, Philipp Mayer, Miriam Klauss, Vladimir Lyadov

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520 |a Since computed tomography (CT) is a part of standard diagnostic protocol in pancreatic ductal adenocarcinoma (PDAC), we have evaluated the value of CT for sarcopenia screening in patients with PDAC, intending to expand the diagnostic value of tomographic studies. In our study, we included 177 patients with available CT images. Two groups were formed: Group 1 consisted of 117 patients with PDAC in various locations and stages and Group 2, or the control group, consisted of 60 "nominally healthy" patients with other somatic non-oncological diseases. The body mass index (BMI) was defined as a ratio of patient's weight to the square of their height (kg/m2). CT-based body composition analysis was performed using commercially available software with evaluation of sarcopenia using skeletal muscle index (SMI, cm2/m2). Based on the SMI values, sarcopenia was found in 67.5% of patients (79 out of 117) in the first patient group. It was found more frequently in males (42 out of 56; 75%) than in females (37 out of 61; 60.6%). Additionally, we observed a decrease in muscle mass (hidden sarcopenia) in 79.7% in patients with a normal BMI. Even in overweight patients, sarcopenia was found in 50% (sarcopenic obesity). In patients with reduced BMI sarcopenia was found in all cases (100%). Statistically significant difference of SMI between two groups was revealed for both sexes (p = 0,0001), with no significant difference between groups in BMI. BMI is an inaccurate value for the assessment of body composition as it does not reflect in the details the human body structure. As SMI may correlate with the prognosis, decreased muscle mass- especially "hidden" sarcopenia or sarcopenic obesity- should be reported. The use of CT-based evaluation of sarcopenia and sarcopenic obesity will allow for a better treatment response assessment in patients with cancer cachexia. 
650 4 |a Cachexia 
650 4 |a Carcinoma, Pancreatic Ductal 
650 4 |a Early Detection of Cancer 
650 4 |a Female 
650 4 |a Humans 
650 4 |a Male 
650 4 |a Muscle, Skeletal 
650 4 |a Obesity 
650 4 |a Pancreatic Neoplasms 
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650 4 |a Retrospective Studies 
650 4 |a Sarcopenia 
650 4 |a Tomography, X-Ray Computed 
650 4 |a Wasting Syndrome 
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