Leveraging real-world data to predict cancer cachexia stage, quality of life, and survival in a racially and ethnically diverse multi-institutional cohort of treatment-naïve patients with pancreatic ductal adenocarcinoma

作者：Jennifer B. Permuth, Margaret A. Park, Dung‐Tsa Chen, Toni L. Basinski, Benjamin Daniel Powers, Clement K. Gwede, Kaleena B. Dezsi, Maria F. Gomez, Shraddha Vyas, Tiago Biachi, Elena M. Cortizas, Sylvia L. Crowder, Maria C. Genilo-Delgado, B.Lee Green, Anna M. Greene, Christopher Gregg, Sarah E. Hoffe, Kun Jiang, Bora Kim, Vanitha Vasudevan, Jeronimo Garcialopez De Llano, Anjana A. Menon, Qianxing Mo, Lina Moreno-Urazan, Shaffer R. S. Mok, Nathan H. Parker, Sahana Rajasekhara, Ghulam Rasool, Andrew J. Sinnamon, Lauren Marie Sparks, Paul A. Stewart, Kenneth Tardif, Alexandra F. Tassielli, Jamie K. Teer, Dan Viet Tran, Kea L. Turner, Susan Thomas Vadaparampil, Christopher J. Whelan, Wade G. Douglas, Vic Velanovich, Andreas Karachristos, Adrian Legaspi, Kenneth Lee Meredith, Manual A. Molina-Vega, Kevin L. Huguet, J. Pablo Arnoletti, Mark Bloomston, Jose Trevino, Nipun B. Merchant, José M. Pimiento, Pamela Joy Hodul, Mokenge Peter Malafa, Jason B. Fleming, Sarah M. Judge, Daniel K. Jeong, Andrew R. Judge · 发表于：Frontiers in Oncology · 年份：2024 · DOI：10.3389/fonc.2024.1362244 · 被引用次数：19 · 研究领域：Nutrition and Health in Aging、Pancreatic and Hepatic Oncology Research、Frailty in Older Adults

Introduction: Cancer-associated cachexia (CC) is a progressive syndrome characterized by unintentional weight loss, muscle atrophy, fatigue, and poor outcomes that affects most patients with pancreatic ductal adenocarcinoma (PDAC). The ability to identify and classify CC stage along its continuum early in the disease process is challenging but critical for management. Objectives: The main objective of this study was to determine the prevalence of CC stage overall and by sex and race and ethnicity among treatment-naïve PDAC cases using clinical, nutritional, and functional criteria. Secondary objectives included identifying the prevalence and predictors of higher symptom burden, supportive care needs, and quality of life (QoL), and examining their influence on overall survival (OS). Materials and methods: A population-based multi-institutional prospective cohort study of patients with PDAC was conducted between 2018 and 2021 by the Florida Pancreas Collaborative. Leveraging patient-reported data and laboratory values, participants were classified at baseline into four stages [non-cachexia (NCa), pre-cachexia (PCa), cachexia (Ca), and refractory cachexia (RCa)]. Multivariate regression, Kaplan Meier analyses, and Cox regression were conducted to evaluate associations. Results: CC stage was estimated for 309 PDAC cases (156 females, 153 males). The overall prevalence of NCa, PCa, Ca, and RCa was 12.9%, 24.6%, 54.1%, and 8.4%, respectively. CC prevalence across all CC stages was ...