Cachexia, dietetic consultation, and survival in patients with pancreatic and periampullary cancer: A multicenter cohort study
Latenstein, Anouk E. J.; Dijksterhuis, Willemieke P. M.; Mackay, Tara M.; Beijer, Sandra; van Eijck, Casper H. J.; de Hingh, Ignace H. J. T.; Molenaar, I. Quintus; van Oijen, Martijn G. H.; van Santvoort, Hjalmar C.; de van der Schueren, Marian A. E.; de Vos-Geelen, Judith; de Vries, Jeanne H. M.; Wilmink, Johanna W.; Besselink, Marc G.; van Laarhoven, Hanneke W. M.
(2020) Cancer Medicine, volume 9, issue 24, pp. 9385 - 9395
(Article)
Abstract
It is unclear to what extent patients with pancreatic cancer have cachexia and had a dietetic consult for nutritional support. The aim was to assess the prevalence of cachexia, dietitian consultation, and overall survival in these patients. This prospective multicenter cohort study included patients with pancreatic cancer, who participated in
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the Dutch Pancreatic Cancer Project and completed patient reported outcome measures (2015–2018). Additional data were obtained from the Netherlands Cancer Registry. Cachexia was defined as self-reported >5% body weight loss, or >2% in patients with a BMI <20 kg/m 2 over the past half year. The Kaplan–Meier method was used to analyze overall survival. In total, 202 patients were included from 18 centers. Cachexia was present in 144 patients (71%) and 81 of those patients (56%) had dietetic consultation. Cachexia was present in 63% of 94 patients who underwent surgery, 77% of 70 patients who received palliative chemotherapy and 82% of 38 patients who had best supportive care. Dietitian consultation was reported in 53%, 52%, and 71%, respectively. Median overall survival did not differ between patients with and without cachexia, but decreased in those with severe weight loss (12 months (IQR 7–20) vs. 16 months (IQR 8–31), p = 0.02), as compared to those with <10% weight loss during the past half year. Two-thirds of patients with pancreatic cancer present with cachexia of which nearly half had no dietetic consultation. Survival was comparable in patients with and without cachexia, but decreased in patients with more severe weight loss.
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Keywords: cachexia, dietetic consultation, nutritional interventions, pancreatic cancer, weight loss, Oncology, Radiology Nuclear Medicine and imaging, Cancer Research
ISSN: 2045-7634
Publisher: John Wiley & Sons Inc.
Note: Funding Information: The Dutch Pancreatic Cancer Project, including the Netherlands Cancer Registry, was support by the Dutch Cancer Society (KWF Kankerbestrijding; grant no. UVA2013-5842). The authors thank the registration team of the Netherlands Cancer Registry for their dedicated data collection. Funding Information: AL has received research funding from Mylan and Allergan. MvO has received unrestricted research grants from BMS, Merck Serono, Nordic, Roche, and Servier. JdV has received non‐financial support and institutional research funding from Servier, outside the submitted work. HvL has served as a consultant for BMS, Celgene, Lilly, Nordic, and Servier, and has received unrestricted research funding from Bayer, BMS, Celgene, Lilly, Merck Serono, MSD, Nordic, Philips, Roche, and Servier. IdH has received an unrestricted research fund paid to the institute from QPS/RanD, ROCHE, and KWF for unrelated research. The other authors have nothing to disclose. Publisher Copyright: © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
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