{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:16:49Z","timestamp":1773933409641,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Progression of cachexia indicated by decreased body weight and composition is associated with poor survival of advanced pancreatic cancer (APC). There are limited data concerning the prognostic effect of cachexia on second\u2010line chemotherapy (L2). We aimed to assess the impact of cachexia progression during first\u2010line therapy (L1) on survival after L2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed patients with gemcitabine\/nab\u2010paclitaxel (GEM\/nabPTX)\u2010refractory APC who underwent L2 with modified FOLFIRINOX or S\u20101 between 2015 and 2019 in our institution. We determined clinicopathological data including body composition parameters: subcutaneous fat area (SFA), visceral fat area (VFA), and skeletal muscle index (SMI). Correlations of changes in these parameters, as well as their effect on overall survival after L2 (OS2), were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median rates of change in SMI, SFA, and VFA were 0.19%, \u22124.17%, and \u221218.39%, respectively, in 59 patients during L1. Although there was moderate correlation in rate of change between SFA and VFA, there was no correlation between SMI and other parameters. We defined loss of SFA, VFA, and SMI as decreases greater than 8.5%, 34.1%, and 8.7%, respectively. Median OS2 of patients with loss in any of these parameters was significantly shorter than in patients without loss (3.83\u00a0vs. 8.73\u00a0months). Multivariate analysis revealed that loss in any parameters, performance status, and C\u2010reactive protein\/albumin ratio were independent negative prognostic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Loss of adipose tissue or skeletal muscle during L1 had a considerable impact on OS2 in APC refractory to GEM\/nabPTX.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajco.13669","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T08:24:46Z","timestamp":1637915086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Loss of adipose tissue or skeletal muscle during first\u2010line gemcitabine\/nab\u2010paclitaxel therapy is associated with worse survival after second\u2010line therapy of advanced pancreatic 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