Prognostic Relationship Between the Cachexia Index and Osteopenia in Patients With Pancreatic Cancer

Background/Aim: The cachexia index (CXI) is a novel biomarker for cancer cachexia. Osteopenia is defined as low bone mineral density (BMD), which is closely associated with cancer cachexia. Osteopenia has received recent attention because of its association with survival outcomes in cancer. The aim of this study was to investigate the relationship between the CXI and BMD in combination as a prognosticator in patients with pancreatic cancer.

Patients and Methods: This study included 121 patients who had undergone pancreatectomy for pancreatic cancer. Data were retrospectively analyzed to evaluate the prognostic relationship between the CXI and BMD.

Results: Five-year overall survival in the high CXI group was significantly better than that in the low CXI group (p= 0.004). Additionally, patients with osteopenia (i.e., low BMD) had significantly worse 5-year overall survival rates than patients without osteopenia (p=0.026). Multivariate analysis revealed that the CXI was an independent prognostic factor for patients with pancreatic cancer (p=0.020). Regarding the combination of the CXI and osteopenia, patients with both low CXI and osteopenia had a worse prognosis compared with patients with other combinations of the CXI and osteopenia (p=0.007). The area under the curve of the combination of the CXI and BMD to predict 5-year overall survival was greater than those of the CXI or BMD alone.

Conclusion: There is a close prognostic relationship between the CXI and osteopenia in patients with pancreatic cancer, and patients with both a low CXI and osteopenia have low survival rates.