{
  "abstract": "Background New prognostic factors are needed to better predict outcomes in pancreatic cancer, a malignancy with a dismal prognosis. Increasing evidence suggests that systemic inflammation and body composition alterations play a major role in cancer progression. This study aimed to evaluate the prognostic impact of pre-treatment systemic inflammation assessed by the modified Glasgow Prognostic Score (mGPS) and platelet-to-lymphocyte ratio (PLR), in comparison with radiological sarcopenia, in patients with pancreatic cancer.Methods A retrospective study including patients diagnosed with pancreatic cancer between 2014 and 2022 was conducted. The modified Glasgow Prognostic Score (mGPS) was calculated based on serum C-reactive protein (CRP) and albumin levels: score 0 for CRP <10 mg/L, score 1 for CRP ≥10 mg/L with albumin ≥35 g/L, and score 2 for CRP ≥10 mg/L with albumin <35 g/L. The platelet-to-lymphocyte ratio (PLR) was calculated from baseline blood counts, and an elevated PLR was defined as a value greater than 200. Sarcopenia was assessed on pre-treatment computed tomography (CT) scans at the level of the third lumbar vertebra using the Total Psoas Area Index (TPAI), normalized for height. Sarcopenia was defined by a TPAI less than 414.5 mm2/m2 for female patients and 564.2 mm2/m2 for male patients. Overall survival was analyzed using the Kaplan–Meier method, and prognostic factors were evaluated using univariate and multivariate analyses.Results Thirty patients were included, with a mean age of 61 ± 11 years and a male predominance (80%). The distribution of mGPS was as follows: score 0 in 25% of patients, score 1 in 40%, and score 2 in 35%. Overall survival was reduced in patients with an mGPS of 2 compared to those with an mGPS of 0 or 1, although the difference was at the limit of statistical significance (p=0.05). Elevated PLR was observed in 46,7% of patients and was associated with increased cancer-related mortality in univariate analysis. Radiologic sarcopenia was observed in 66% of patients. Kaplan–Meier analysis showed a significant difference in survival between sarcopenic and non-sarcopenic patients (log-rank test p=0.01), with a hazard ratio of 2.95 (95% CI: 1–7). In multivariate analysis, sarcopenia remained an independent prognostic factor for mortality (OR=3.25; 95%CI [1.02-15.45]; p=0.03), whereas systemic inflammation markers (mGPS and PLR) showed a non-independent association with survival.Conclusions Pre-treatment systemic inflammation and sarcopenia are associated with poor prognosis in pancreatic cancer. Among the evaluated factors, radiological sarcopenia appears to be the strongest independent predictor of mortality, outperforming inflammatory markers such as mGPS and PLR. Incorporating body composition and inflammatory parameters into routine pre-treatment assessment may improve risk stratification and patient management.",
  "authors": [
    {
      "affiliations": [
        "Internal Security Forces Hospital La Marsa, Tunis, Tunisia"
      ],
      "name": "Myriam Ayari"
    },
    {
      "affiliations": [
        "Internal Security Forces Hospital La Marsa, Tunis, Tunisia"
      ],
      "name": "Sarra Ben Azouz"
    },
    {
      "affiliations": [
        "Internal Security Forces Hospital La Marsa, Tunis, Tunisia"
      ],
      "name": "Amira Chehaider"
    },
    {
      "affiliations": [
        "Internal Security Forces Hospital La Marsa, Tunis, Tunisia"
      ],
      "name": "Taieb Jomni"
    }
  ],
  "title": "FP40 Prognostic impact of pre-treatment systemic inflammation and sarcopenia in pancreatic cancer",
  "uid": "69b26a30-1213-502c-8849-37d2ce55ab46"
}