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Pancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome prediction

dc.contributor.authorCardoso, Debora
dc.contributor.authorMatos, Leonor Vasconcelos
dc.contributor.authorFernandes, Leonor
dc.contributor.authorDomingues, Tiago Dias
dc.contributor.authorSão João, Ricardo
dc.contributor.authorMirra, Renata Medeiros
dc.contributor.authorMiranda, Helena
dc.contributor.authorMartins, Ana
dc.date.accessioned2020-03-25T15:29:15Z
dc.date.available2020-03-25T15:29:15Z
dc.date.issued2020-01
dc.description.abstractCancer-associated-cachexia (CAC) is a ubiquitous characteristic of pancreatic cancer (PC) and 1/3 of patients die from its complications. Systemic inflammation is key in CAC and the modified Glasgow Prognostic Score (mGPS) is a reliable inflammation-based prognostic tool. We aimed to evaluate the prognostic value of consensus-based cachexia classification and mGPS, their agreement and to analyze relevant clinical predictors of cachexia. This unicentric, retrospective, cohort study included patients with advanced PC treated over a 5-year period. Cachexia was classified according to weight loss, body mass index and mGPS. Fisher’s test was used to test correlation between classifications and logistic regression models were performed to test their association with other variables. Survival was analyzed with cox regression and Kaplan-Meier curves. 88 eligible patients (mean age 72, 56% female) were reviewed. At baseline, cachectic patients (CP) (77%), when compared with pre-CP, had worse performance status (p=0.016), more NLR>3,5 (p<0.01) and hypoalbuminemia (p 0.01). Of 77% (n=68) categorized as cachectic, only 16% (n=8) had a positive mGPS. No association was found between classifications (p=0.187). In multivariate analysis, NLR>3.5 was a significant predictor of both cachexia (p<0.001) and positive mGPS (p<0.01). Median overall survival (OS) for pre-CP was 19.1 months vs. 4.9 months in the CP (HR 1.94 95% CI 1.10-3.43 p=0.02). A positive mGPS at baseline was an independent predictor of worst OS (HR 2.73, 95% CI 1.126.66, p=0.027). CAC leads to worst survival and a better understanding of this syndrome in PC may improve outcomes for these patients. Our study suggests a baseline predominant fat-only loss phenotype, that patients with positive mGPS are at higher risk of worst outcomes and that NLR is a potential predictor of CAC. A prompt identification of prognostic markers may lead to a better standardized management of CA.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.issn2324-9110
dc.identifier.urihttp://hdl.handle.net/10400.15/2853
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSciTechnolpt_PT
dc.relation.publisherversionhttps://www.scitechnol.com/peer-review/pancreatic-cancer-associatedcachexia-role-of-the-modified-glasgow-prognostic-score-in-outcome-prediction-4wJQ.php?article_id=10710pt_PT
dc.subjectCachexiapt_PT
dc.subjectPancreatic cancerpt_PT
dc.subjectModified Glasgow prognostic scorept_PT
dc.subjectWright losspt_PT
dc.subjectNeutrophil to lymphocyte ratiopt_PT
dc.titlePancreatic câncer associatedCachexia:role of the modified Glasgow prognostic score in outcome predictionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceLondonpt_PT
oaire.citation.issue1pt_PT
oaire.citation.titleJournal of Clinical & Experimental Oncologypt_PT
oaire.citation.volume9pt_PT
person.familyNameSão João
person.givenNameRicardo
person.identifier.ciencia-id8E1B-AFBF-E940
person.identifier.orcid0000-0003-3137-0891
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication7501922f-cbe1-4a1b-8bd6-21c777f269e2
relation.isAuthorOfPublication.latestForDiscovery7501922f-cbe1-4a1b-8bd6-21c777f269e2

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