title: Influence of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma: a systematic review.
abstract: OBJECTIVE
  Cachexia affects ∼ 80% of pancreatic cancer patients. An international consensus defines cachexia as an ongoing loss of skeletal muscle mass (sarcopenia) with or without loss of fat, which impairs body functioning and cannot be reversed by conventional nutritional measures. Weight loss percentage and elevated inflammation markers have been employed to define this condition earlier. This review aimed to assess the prevalence and consequences of cachexia and sarcopenia on survival in patients with pancreatic ductal adenocarcinoma.
  
  
  METHODS
  The systematic review was performed by searching the articles with preset terms published in PubMed and Cochrane Database until December 2013. After identifying relevant titles, abstracts were read and eligible articles data retrieved on preformatted sheets. The prevalence and impact of sarcopenia/cachexia on survival was evaluated.
  
  
  RESULTS
  In total 1145 articles were retrieved, only 10 were eligible. Definitions of cachexia and sarcopenia were heterogeneous. In patients with normal weight (BMI 18.5-24.9 kg/m(2)) the prevalence of sarcopenia ranged from 29.7 to 65%. In overweight or obese patients (BMI >25 kg/m(2)) were 16.2%-67%. Sarcopenia alone was not demonstrated to be an independent factor of decreased survival, although obese sarcopenic patients were shown to have significantly worse survival in two studies.
  
  
  CONCLUSIONS
  Impact of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma is currently understudied in the available literature. Definitive association between cachexia and survival cannot be drawn from available studies, although weight loss and sarcopenic obesity might be considered as poor prognostic factors. Further prospective trials utilizing the consensus definition of cachexia and including other confounding factors are needed to investigate the impact of cachexia and sarcopenia on survival in pancreatic adenocarcinoma.
authors.affiliation: Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors.forename: I
authors.initials: I
authors.lastname: Ozola Zalite
authors.affiliation: Hospital of Lithuanian University of Health Sciences Kaunas, Lithuania.
authors.forename: R
authors.initials: R
authors.lastname: Zykus
authors.affiliation: Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Francisco Gonzalez
authors.affiliation: Department of Gastroenterology Pamukkale University, Denizli, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Saygili
authors.affiliation: Pauls Stradins Clinical University Hospital, Riga, Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia.
authors.forename: A
authors.initials: A
authors.lastname: Pukitis
authors.affiliation: Department of Digestive and Endocrine Surgery, Cochin Hospital, APHP, Paris, France; Faculté de Medecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: S
authors.initials: S
authors.lastname: Gaujoux
authors.affiliation: North East's Hepato-Pancreato-Biliary Centre at the Freeman Hospital, Newcastle, United Kingdom.
authors.forename: R M
authors.initials: RM
authors.lastname: Charnley
authors.affiliation: Department of Surgical Oncology, Medical and Rehabilitation Center under the Ministry of Health of Russian Federation, Moscow, Russia. Electronic address: vlyadov@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Lyadov
mesh_terms: D002100:Cachexia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications* / Q000401:mortality; D006801:Humans; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000401:mortality; D015995:Prevalence; D011379:Prognosis; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015996:Survival Rate; D015431:Weight Loss
keywords: Cachexia; Malnutrition; Pancreatic adenocarcinoma; Pancreatic neoplasm; Sarcopenia; Survival