Impact of sarcopenia on survival of pancreatic cancer patients treated with concurrent chemoradiotherapy

Purpose: To investigate the prognostic impact of sarcopenia on the survival of patients with locally advanced pancreatic cancer (LAPC) treated with concurrent chemoradiotherapy (CCRT). Methods: We retrospectively reviewed 299 patients diagnosed with LAPC and treated with definitive CCRT from 2000 to 2015. Skeletal muscle index (SMI) was measured using computed tomography scans and sarcopenia was defined as SMI <29.6 cm(2)/m(2)for women and <36.2 cm(2)/m(2)for men. The significance of sarcopenia for progression-free survival (PFS) and overall survival (OS) was evaluated. Results: Sarcopenia was present in 29 patients (9.7%). In multivariate analysis, sarcopenia was a significant factor for PFS (p= 0.043). Although sarcopenia was not a significant factor for OS (p= 0.121) in multivariate analysis, long-term survivors were observed only in the no sarcopenia group (OS at 60 months: 9.5% vs 0%,p< 0.001). Conclusion: In patients undergoing CCRT for LAPC, sarcopenia is an independent factor for adverse prognosis.