Abstract

Background

Sarcopenia and myosteatosis have been associated with a poor prognosis for several cancers. The albumin-myosteatosis gauge (AMG) is a novel integrated measure proposed to assess myosteatosis along with serum albumin level as a surrogate of systemic inflammation and malnutrition. The aim of this study was to investigate the prognostic value of AMG in patients with advanced pancreatic ductal adenocarcinoma (PDAC).

Methods

Patients with advanced PDAC treated with chemotherapy between 2013 and 2022 were evaluated. Skeletal muscle radiodensity (SMD) and skeletal muscle index (SMI) were calculated using computed tomography at the level of the L3 vertebra. The AMG was defined as albumin x SMD and expressed as an arbitrary unit (AU). Patients were first categorized by sex-specific quartiles and then dichotomized at the sex-specific median value of the AMG.

Results

A total of 196 patients were included. The median age (interquartile range) was 62 (54–67), and 128 (65.3%) were male. With regard to AMG, 142.86 and 114.15 AU were identified as cutoff values for males and females, respectively. In multivariable analyses, lower AMG values (G1-G2 vs. G3-G4) (HR: 1.61, 95% CI 1.17–2.21, p = 0.003), higher ECOG performance score (> 0 vs. 0) (HR: 1.51, 95% CI 1.10–2.06, p = 0.009) and metastatic disease (vs. locally advanced) (HR: 1.88, 95% CI 1.27–2.79, p = 0.001) were associated with OS.

Conclusion

The study findings suggest the prognostic value of AMG in patients with advanced PDAC undergoing first-line chemotherapy. Further studies are warranted to validate these findings and assess potential predictive role of AMG in guiding treatment selection.

中文翻译：

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白蛋白肌脂肪变性测量仪作为接受一线化疗的晚期胰腺癌患者的预后因素

摘要

背景

肌肉减少症和肌脂肪变性与多种癌症的不良预后有关。白蛋白肌脂肪变性测量仪 (AMG) 是一种新颖的综合测量方法，旨在评估肌脂肪变性以及血清白蛋白水平，作为全身炎症和营养不良的替代指标。本研究的目的是探讨 AMG 对晚期胰腺导管腺癌 (PDAC) 患者的预后价值。

方法

对 2013 年至 2022 年间接受化疗的晚期 PDAC 患者进行了评估。使用 L3 椎骨水平的计算机断层扫描计算骨骼肌放射密度 (SMD) 和骨骼肌指数 (SMI)。 AMG被定义为白蛋白x SMD并表示为任意单位(AU)。首先根据性别特异性四分位数对患者进行分类，然后根据性别特异性 AMG 中值进行二分。

结果

总共包括 196 名患者。中位年龄（四分位距）为 62 岁（54-67 岁），其中 128 名（65.3%）为男性。对于 AMG，男性和女性的截止值分别为 142.86 和 114.15 AU。在多变量分析中，较低的 AMG 值（G1-G2 与 G3-G4）（HR：1.61，95% CI 1.17–2.21，p  = 0.003），较高的 ECOG 表现评分（> 0 与 0）（HR：1.51， 95% CI 1.10–2.06，p  = 0.009）和转移性疾病（相对于局部晚期）（HR：1.88，95% CI 1.27–2.79，p  = 0.001）与 OS 相关。

结论

研究结果表明 AMG 对接受一线化疗的晚期 PDAC 患者的预后价值。需要进一步的研究来验证这些发现并评估 AMG 在指导治疗选择方面的潜在预测作用。