Prognostic value of body composition on early recurrence and long-term survival of resectable pancreatic ductal adenocarcinoma

作者：Linxia Wu, Tong Nie, Xiaoling Zhi, Die Ouyang, Licai Zhang, Hongying Wu, Xin Li, Heshui Wu, Ping Han, Lei Chen, Feihong Wu, Chuansheng Zheng · 发表于：European Radiology · 年份：2025 · DOI：10.1007/s00330-025-12028-8 · 被引用次数：3 · 研究领域：Nutrition and Health in Aging、Pancreatic and Hepatic Oncology Research、Inflammatory Biomarkers in Disease Prognosis

OBJECTIVE: To explore the associations of CT-evaluated body composition with early recurrence (ER) and overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC) after resection. MATERIALS AND METHODS: A retrospective analysis was performed on consecutively enrolled patients who underwent surgical resection for PDAC between 2014 and 2023. Patients were divided into a training set (n = 412) and a validation set (n = 120). Sex-specific cutoff values were determined for body composition indices, including visceral-to-subcutaneous fat ratio (VSR), skeletal muscle density (SMD), subcutaneous fat area (SFA), and other metrics. Logistic regression and Cox proportional hazards models were used to analyze the associations of body composition with ER and OS. Subgroup analyses were conducted based on clinicopathological characteristics to explore the prognostic value of body composition. RESULTS: High VSR was an independent predictor for ER (OR: 2.304, p = 0.001) and worse OS (HR: 1.462, p = 0.007), whereas high SMD (HR: 0.609, p = 0.005) and high SFA (HR: 0.649, p = 0.002) were independent predictors for better OS. Subgroup analyses revealed variations in the prognostic effect of VSR according to diabetes status and tumor size. A model combining body composition metrics and clinicopathological indicators (carbohydrate antigen 19-9, carbohydrate antigen 12-5, tumor-node-metastasis stage, lymphovascular invasion, and adjuvant therapy) demonstrated good predictive abil...