title: Impact of presence and degree of pretreatment weight loss in locally-advanced pancreatic cancer patients treated with definitive concurrent chemoradiotherapy.
abstract: BACKGROUND
  To assess the impact of the presence and degree of pretreatment weight loss (WL) on the survival of locally-advanced pancreas cancer (LAPC) patients treated with concurrent chemoradiotherapy (C-CRT).
  
  
  METHODS
  Seventy-three patients who received 50.4 Gy C-CRT were analyzed. All patients underwent laparoscopy (n = 18) or laparotomy (n = 55), and biopsies were obtained for histologic examination of the primary tumor and enlarged/metabolically active regional lymph nodes. Pretreatment WL and percentage WL (PWL) were calculated by utilizing data obtained 6 months prior to and during hospital admission. The primary objective was to assess the influence WL status on overall survival (OS), and the secondary objective was the identification of a PWL cut-off value, if available.
  
  
  RESULTS
  Forty-five (61.6%) patients had WL. Median OS was 14.4 months for the entire study population which was significantly longer in the non-WL than the WL cohort (21.4 vs. 11.3 months; p < 0.003). On further analysis a cut-off value of 3.1% was identified for WL. Accordingly, patients with WL < 3.1% had significantly longer OS than those with WL ≥ 3.1% (25.8 vs. 10.1 months; p < 0.001). In multivariate analysis, both the WL status (p < 0.001) and PWL (p = 0.002) retained their independent significance.
  
  
  CONCLUSIONS
  Both the presence and degree of WL prior to C-CRT had strong adverse effects on the survival of LAPC patients, even if they presented with a BMI > 20 kg/m(2). Additionally, a WL of ≥3.1% in the last 6 months appeared to be a strong cut-off for the stratification of such patients into distinctive survival groups.
authors.affiliation: Baskent University Adana Medical Faculty, Department of Radiation Oncology, Adana, Turkey. Electronic address: bernaakkus@yahoo.com.
authors.forename: Berna Akkus
authors.initials: BA
authors.lastname: Yildirim
authors.affiliation: Baskent University Adana Medical Faculty, Department of Radiation Oncology, Adana, Turkey.
authors.forename: Yurday
authors.initials: Y
authors.lastname: Özdemir
authors.affiliation: Baskent University Adana Medical Faculty, Department of General Surgery, Adana, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Colakoglu
authors.affiliation: Baskent University Adana Medical Faculty, Department of Radiation Oncology, Adana, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Topkan
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Concurrent chemoradiotherapy; Locally-advanced pancreatic carcinoma; Percentage weight loss; Pretreatment weight loss; Survival; Weight loss degree