Highlights
- •Neoadjuvant chemotherapy is become more popular for pancreatic cancer.
- •There are no patient-centered metrics to predict response to neoadjuvant therapy.
- •Most patients lose or maintain weight during neoadjuvant therapy.
- •Weight loss does not predict poor outcomes.
Abstract
Background
Weight changes during neoadjuvant chemotherapy (NAC) for pancreatic cancer (PDAC)
are not well studied. We hypothesized that weight loss may predict poor outcomes.
Methods
Weight change from NAC initiation to pancreatectomy was grouped: gain (≥5%), stable,
and loss (≥5%). Pathologic, postoperative, and survival outcomes were compared.
Results
95 patients were included: 31.6% lost weight, 58.9% maintained weight, and 9.5% gained
weight. There were no differences in chemotherapeutic regimens. Median recurrence-free
survival (RFS) and overall survival (OS) were similar between patients with stable
weight and those who lost weight (RFS: 9.6vs14.0months; OS: 25.8vs26.7months). Among
those who gained weight, RFS (29.5months) and OS (38.4months) were greater relative
to the other weight categories. On multivariable regression, weight gain was associated
with improved RFS compared to loss (HR = 0.16).
Conclusion
Most patients maintain or lose weight during NAC, and weight loss does not predict
poor outcomes. Weight gain may predict improved RFS.
Keywords
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Article info
Publication history
Published online: October 07, 2021
Accepted:
October 3,
2021
Received in revised form:
September 18,
2021
Received:
September 4,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
