Psoas muscle mass, nutritional situation, inflammation and prognosis in patients with pancreas adenocarcinoma

INTRODUCTION AND AIM: In patients diagnosed with pancreatic cancer, some parameters such as patient's age, tumor size, stage of the disease, lymph node metastasis, tumor grade and serum CA19-9 level have been shown to be associated with survi duration. There are researches that the presence of malnutrition, sarcopenia and inflammation may also have an effect on patients' life span in patients diagnosed with malignancy recently. In this study, it was aimed to investigate the relationship between psoas muscle mass, nutritional status and inflammation at the time of diagnosis in patients with pancreatic cancer and the survival time of patients. MATERIAL AND METHODS: In this study, 219 patients diagnosed with pancreatic cancer who applied to the Oncology Outpatient Clinic of Sakarya University Training and Research Hospital between January 2015 and January 2019 were analyzed retrospectively. Clinical, demographic and laboratory data of the patients were obtained from the records in the outpatient files. The anamnesis, examination findings, laboratory and imaging results of the patients at the outpatient clinic were evaluated. Nutritional status of patients, psoas muscle mass and inflammation status were determined and recorded from the measurements obtained. The relationship between the nutritional status of the patients at the time of diagnosis, the presence of psoas muscle mass, the presence of sarcopenia, inflammation status and their prognosis was investigated. 1. Nutritional status assessment: Prognostic nutritional index (PNI) of the patients was calculated by the number of serum albumin and lymphocytes in their examinations. The calculation was made with the formula of 10 x serum albumin (g / L) + 5 x lymphocyte count (109/L). 2. Inflammation assessment: Routine complete blood count leukocyte count and neutrophil / lymphocyte ratio were used in the outpatient follow-up of the patients. 3. Psoas Muscle Mass Measurement: Psoas muscle mass was measured from the abdominal computed tomography imaging of patients. NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program was used for statistical analysis. While evaluating the study data, descriptive statistical methods (Mean, Standard Deviation, Median, Frequency, Rate, Minimum, Maximum) as well as the distribution of the data were evaluated with the Shapiro-Wilk Test. Mann-Whitney U Test was used to compare two groups that did not show normal distribution of quantitative data. Regression analysis was used to determine the effect of independent variables on the dependent variable. Kaplan Meier method was used to compare survival processes as a group. Significance was evaluated at p <0.01 and p <0.05 levels. RESULTS: In our study, when the retrospective information of the patients was examined, 36.5% (n = 80) of the patients were female while 63.5% (n = 139) were male. The average age of all patients; 66.64 ± 11.7 (min: 23, max: 87). The average age of men; 67.59 ± 9.43 (min: 38, max: 87) the average age of women; It was calculated as 65 ± 14.76 (min: 23, max: 87). Male / female ratio; It was 1.73. In the study, BMI of 63 patients, 42 male and 21 female, could be calculated. The BMI average of these 63 patients; It was found to be 24.2 ± 5.46 (min: 15.02, max: 41.09). BMI average of men; 26.14 ± 6.16 (min: 18.73 max: 41.09) women BMI average; It was calculated as 23.23 ± 4.87 (min: 15.02, max: 37.5). In the analyzed data, the psoas area of 191 patients was found to be 647.23 ± 252.48 (min: 209, max: 1762). While this ratio was 463,29 ± 136,47 (min: 209, max: 960) in females, it was found to be 749,07 ± 244,4 (min: 221, max: 1762) in males. In the data obtained, 70% (n: 155) of the patients had no malnutrition, while 30% (n: 64) had malnutrition. While the average age of the patients without malnutrition was 65.54 ± 11.47 (min: 36, max: 84), the average age was 69.05 ± 8.56 (min: 48, max: 88) in those with malnutrition. CONCLUSION: According to our study results, patients with pancreatic adeoncarcinoma had a shorter duration of survival in patients with malnutrition during diagnosis than patients with normal nutrition. There is no relationship between psoas muscle mass, presence of sarcopenia or neutrophil / lymphocyte ratio and survival time at the time of diagnosis. We are of the opinion that a prospective study, which includes different parameters showing sarcopenia, malnutrition and inflammation, can be useful.