{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:36:20Z","timestamp":1787060180964,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Charit\u00e9","award":["#51432176"],"award-info":[{"award-number":["#51432176"]}]},{"name":"B. Braun GmbH Germany","award":["#51432176"],"award-info":[{"award-number":["#51432176"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Pancreatic adenocarcinoma (PDAC) is still a complex, devastating disease. Cachexia symptoms frequently impair patient survival. This accompanying syndrome is commonly diagnosed late, when clinical signs become evident. Early diagnosis using conventional measurement methods is often difficult, and the discrimination of this disease from cancer progression is challenging and often overlaps. The aim of this study was to analyze whether conventional nutritional assessments or laboratory biomarkers are better predictive tools for the early detection of patients at risk of reduced survival. Methods: We analyzed a prospective predefined cohort of 182 patients with gastrointestinal cancer, 120 patients with PDAC and\u2014as controls\u201462 patients with other gastrointestinal adenocarcinoma (oAC), from whom we have sufficient data of protocol-defined conventional nutritional assessments, clinical data, and specific laboratory parameters. Results: at the time of tumor diagnosis, high inflammatory biomarkers (c-reactive protein (CRP), interleukin-6 (IL-6)) and albumin serum levels were associated with impaired OS in PDAC patients, but not in patients with oAC. Hemoglobin, body mass index (BMI), and bioelectrical assessments alone did not have a prognostic impact at the time of diagnosis. In a multivariate analysis, only CRP (HR 1.91 (1.25\u20132.92), p = 0.003) was found to be an independent prognostic factor in PDAC patients. Over the course of the disease in PDAC patients, inflammatory biomarkers, albumin, hemoglobin, and bioelectrical assessments were associated with impaired OS. In multivariate testing, CRP (HR 2.21 (1.38\u20133.55), p &lt; 0.001) and albumin (HR 1.71 (1.05\u20132.77), p = 0.030) were found to be independent prognostic factors in PDAC patients. Conclusion: Specifically for PDAC patients, high inflammatory index and albumin serum levels potentially represent a sufficient early surrogate marker to detect patients at high risk of impaired OS better than complex conventional methods. These findings could help to identify patients who may benefit from early therapeutic interventions.<\/jats:p>","DOI":"10.3390\/cancers16061194","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T04:36:31Z","timestamp":1710822991000},"page":"1194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cachexia-Affected Survival Based on Inflammatory Parameters Compared to Complex Conventional Nutritional Assessments in Patients with Pancreatic Cancer and Other Gastrointestinal Tumors\u2014The CONKO 020 Investigation"],"prefix":"10.3390","volume":"16","author":[{"given":"Johanna W.","family":"Meyer-Knees","sequence":"first","affiliation":[{"name":"Division of Oncology and Hematology, Berlin Institute of Health, Charite Campus Virchow Klinikum, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5121-2909","authenticated-orcid":false,"given":"Janina","family":"Falkenthal","sequence":"additional","affiliation":[{"name":"KONZ-E-B-T CARE GmbH Zentrum f\u00fcr Ern\u00e4hrung, Beatmung und Therapie, 13435 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Geisel","sequence":"additional","affiliation":[{"name":"Division of Radiology, Berlin Institute of Health, Charite Campus Virchow Klinikum, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9009-8678","authenticated-orcid":false,"given":"Christopher C. M.","family":"Neumann","sequence":"additional","affiliation":[{"name":"Division of Oncology and Hematology, Berlin Institute of Health, Charite Campus Mitte, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Hilfenhaus","sequence":"additional","affiliation":[{"name":"Division of Oncology and Hematology, Berlin Institute of Health, Charite Campus Mitte, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars U.","family":"Stephan","sequence":"additional","affiliation":[{"name":"Division of Oncology and Hematology, Berlin Institute of Health, Charite Campus Mitte, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzel","family":"Sch\u00f6ning","sequence":"additional","affiliation":[{"name":"Division of Surgery, Berlin Institute of Health, Charite Campus Mitte-Campus Virchow Klinikum, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5860-5710","authenticated-orcid":false,"given":"Thomas","family":"Malinka","sequence":"additional","affiliation":[{"name":"Division of Surgery, Berlin Institute of Health, Charite Campus Mitte-Campus Virchow Klinikum, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Pratschke","sequence":"additional","affiliation":[{"name":"Division of Surgery, Berlin Institute of Health, Charite Campus Mitte-Campus Virchow Klinikum, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3297-5801","authenticated-orcid":false,"given":"Sebastian","family":"Stintzing","sequence":"additional","affiliation":[{"name":"Division of Oncology and Hematology, Berlin Institute of Health, Charite Campus Mitte, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9213-2737","authenticated-orcid":false,"given":"Uwe","family":"Pelzer","sequence":"additional","affiliation":[{"name":"Division of Oncology and Hematology, Berlin Institute of Health, Charite Campus Mitte, Freie Universit\u00e4t Berlin, Humboldt Universit\u00e4t zu Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1002\/cam4.767","article-title":"Projections of cancer incidence and cancer-related deaths in Germany by 2020 and 2030","volume":"5","author":"Quante","year":"2016","journal-title":"Cancer Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.1158\/0008-5472.CAN-14-0155","article-title":"Projecting cancer incidence and deaths to 2030: The unexpected burden of thyroid, liver, and pancreas cancers in the United States","volume":"74","author":"Rahib","year":"2014","journal-title":"Cancer Res."},{"key":"ref_3","unstructured":"Gesellschaft der Epidemiologischen Krebsregister in Deutschland e. 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