{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T15:03:58Z","timestamp":1778771038142,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T00:00:00Z","timestamp":1732320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T00:00:00Z","timestamp":1732320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF\u20102022R1C1C1005415"],"award-info":[{"award-number":["NRF\u20102022R1C1C1005415"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1F1A1074362"],"award-info":[{"award-number":["2022R1F1A1074362"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with borderline resectable (BR) or locally advanced pancreatic cancer (LAPC) require complex management strategies. This study evaluated the prognostic significance of the perichemotherapy skeletal muscle index (SMI) and carbohydrate antigen 19\u20109 (CA 19\u20109) in patients with BRPC or LAPC treated with FOLFIRINOX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated 227 patients with BR or LAPC who received at least four cycles of chemotherapy between 2015 and 2020. We analysed chemotherapy response, changes in SMI (\u0394SMI, %) on computed tomography (CT) and CA19\u20109 to determine their impact on progression\u2010free survival (PFS) and overall survival (OS). After the early application of loco\u2010regional treatments (LRT) within 3\u2009months after completing four cycles of chemotherapy, the outcomes were compared between \u0394SMI and CA19\u20109 subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 227 patients (median age, 60\u2009years; 124 [54.6%] male) with 97 BR and 130 LAPC, 50.7% showed partial response (PR) to chemotherapy, 44.5% showed stable disease and 4.8% showed progressive disease (PD). Post\u2010chemotherapy CA19\u20109 levels were normalized in 41.0% of patients. The high and low \u0394SMI groups (based on the gender\u2010specific cut\u2010off of \u22128.6% for males and \u22122.9% for females) comprised 114 (50.2%) and 113 (49.8%) patients, respectively. The high \u0394SMI group had poorer survival rates than the low \u0394SMI group in both PFS (HR\u2009=\u20091.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05) and OS (HR\u2009=\u20091.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Multivariable analysis showed that \u0394SMI (high vs. low; PFS, HR\u2009=\u20091.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03; OS, HR\u2009=\u20091.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and post\u2010chemotherapy response (PD vs. PR\/SD; PFS, HR\u2009=\u200918.69,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; OS, HR\u2009=\u20096.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were independently associated with both PFS and OS. Additionally, the post\u2010chemotherapy CA19\u20109 (\u2265\u200937 vs. &lt;\u200937; HR\u2009=\u20091.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) was an independent predictor for PFS. Early application of LRT after chemotherapy significantly improved PFS and OS in both \u0394SMI groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). However, it was not beneficial in the group with high \u0394SMI and post\u2010chemotherapy CA19\u20109\u2009\u2265\u200937 (PFS,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.39 and OS,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.33).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Progressive sarcopenic deterioration after four cycles of chemotherapy was associated with poor survival outcomes in patients with BR or LAPC after FOLFIRINOX. We also investigated the optimal clinical setting for the early application LRTs using the \u0394SMI and post\u2010chemotherapy CA 19\u20109.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13643","type":"journal-article","created":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T03:38:08Z","timestamp":1732333088000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Skeletal Muscle Index Changes on Locoregional Treatment Application After FOLFIRINOX and Survival in Pancreatic Cancer"],"prefix":"10.1002","volume":"16","author":[{"given":"Ji\u00a0Hye","family":"Min","sequence":"first","affiliation":[{"name":"Department of Radiology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-7263","authenticated-orcid":false,"given":"Jeong\u00a0Il","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong\u00a0Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young\u00a0Kon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kangpyo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee\u00a0Chul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon\u00a0Oh","family":"Park","sequence":"additional","affiliation":[{"name":"Divisions of Hematology\u2010Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u00a0Yong","family":"Hong","sequence":"additional","affiliation":[{"name":"Divisions of Hematology\u2010Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyu\u00a0Taek","family":"Lee","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwang\u00a0Hyuck","family":"Lee","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong\u00a0Kyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joo\u00a0Kyung","family":"Park","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u00a0Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Divisions of Gastroenterology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u00a0Seok","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00a0Woong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbeom","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang\u00a0Hyun","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"So\u00a0Jung","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sook\u2010young","family":"Woo","sequence":"additional","affiliation":[{"name":"Biomedical Statistics 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