Weight Loss as an Untapped Early Detection Marker in Pancreatic and Periampullary Cancer.
Publication/Presentation Date
10-1-2021
Abstract
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has the worst survival of common cancers, partly because there are no reliable early detection tests. Unintentional weight loss (≥ 5% decrease from baseline) has been linked to PDAC, but the frequency and severity of weight loss using objective measures, and its relationship to prognosis, have not been well characterized.
METHODS: We identified 390 patients with PDAC (all stages) and two or more prediagnosis weights in the electronic medical record. Percentage weight loss in the 365 and 180 days preceding diagnosis was calculated. Results were compared with raw weights of age- and sex-matched non-cancer controls (n = 780). Odds ratios for PDAC were calculated using conditional logistic regression. Cox proportional hazards models were used for survival.
RESULTS: Within 1 year of diagnosis, more PDAC patients lost ≥ 5% weight relative to controls (74.9% vs. 11.2%; p < 0.001), with a median weight loss of 14.2 versus 2.9 lbs. The odds ratio for PDAC comparing weight loss within 1 year of 5 to < 10% was 10.30 (p < 0.001) and 77.82 for ≥ 10% (p < 0.001), compared with stable weight. Weight loss prior to diagnosis was also associated with early-stage PDAC. PDAC cases with ≥ 10% prediagnosis weight loss had worse survival compared with stable weights (hazard ratio [HR] 1.60; p = 0.01). Greater prediagnosis weight loss was associated with poor survival after pancreatectomy (5 to < 10% vs. < 5%, HR 2.40, p = 0.03; ≥ 10% vs. < 5%, HR 2.59, p = 0.03).
CONCLUSIONS: Diagnosis of PDAC is preceded by unintentional weight loss in the majority of patients, even at an early stage. Greater prediagnosis weight loss severity is also associated with poor postoperative survival.
Volume
28
Issue
11
First Page
6283
Last Page
6292
ISSN
1534-4681
Published In/Presented At
Hue, J. J., Sugumar, K., Kyasaram, R. K., Shanahan, J., Lyons, J., Ocuin, L. M., Rothermel, L. D., Hardacre, J. M., Ammori, J. B., Rao, G., Winter, J. M., & Markt, S. C. (2021). Weight Loss as an Untapped Early Detection Marker in Pancreatic and Periampullary Cancer. Annals of surgical oncology, 28(11), 6283–6292. https://doi.org/10.1245/s10434-021-09861-8
Disciplines
Medicine and Health Sciences
PubMedID
33835301
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article
