■癌症相关恶病质(CC)是一种进行性综合征,其特征是无意的体重减轻,肌肉萎缩,疲劳,和影响大多数胰腺导管腺癌(PDAC)患者的不良结局。在疾病过程的早期识别和分类CC阶段的能力具有挑战性,但对于管理至关重要。
■本研究的主要目的是使用临床方法确定初治PDAC病例中CC阶段总体和性别、种族和民族的患病率,营养,和功能标准。次要目标包括确定较高症状负担的患病率和预测因素,支持性护理需求,和生活质量(QoL),并检查它们对总生存期(OS)的影响。
■一项基于人群的多机构前瞻性队列研究PDAC患者于2018年至2021年由佛罗里达胰腺协作组织进行。利用患者报告的数据和实验室值,参与者在基线时分为四个阶段[非恶病质(NCa),恶病质前期(PCa),恶病质(Ca),和难治性恶病质(RCa)]。多元回归,KaplanMeier分析,并进行Cox回归评估相关性.
■估计309例PDAC的CC阶段(156名女性,153名男性)。NCa的总体患病率,PCa,Ca,RCa为12.9%,24.6%,54.1%,和8.4%,分别。在所有CC阶段中,男性,种族和少数民族的CC患病率最高。标准将NCa病例与其他组区分开来,但没有区分PCa和Ca。最常见的症状包括体重减轻,疲劳,疼痛,焦虑,和抑郁症,随着时间的推移,疼痛明显恶化。最大的支持性护理需求包括情感和身体领域。男性,黑人,那些有RCa的人操作系统最差。
■使用临床,营养,和功能标准,在我们多样化的PDAC病例中,近四分之一,多机构队列在诊断时患有PCa,62.5%的患者患有Ca或RCa.PCa估计值高于先前研究中报道的。我们建议使用这些标准来帮助CC分类,监测,以及所有事故PDAC病例的管理。调查结果还强调了持续情感支持的建议,帮助减轻疼痛,以及整个PDAC治疗过程中的支持性护理需求。
UNASSIGNED: Cancer-associated cachexia (CC) is a progressive syndrome characterized by unintentional weight loss, muscle atrophy, fatigue, and poor outcomes that affects most patients with pancreatic ductal adenocarcinoma (PDAC). The ability to identify and classify CC stage along its continuum early in the disease process is challenging but critical for management.
UNASSIGNED: The main objective of this study was to determine the prevalence of CC stage overall and by sex and race and ethnicity among treatment-naïve PDAC cases using clinical, nutritional, and functional criteria. Secondary objectives included identifying the prevalence and predictors of higher symptom burden, supportive care needs, and quality of life (QoL), and examining their influence on overall survival (OS).
UNASSIGNED: A population-based multi-institutional prospective cohort study of patients with PDAC was conducted between 2018 and 2021 by the Florida Pancreas Collaborative. Leveraging patient-reported data and laboratory values, participants were classified at baseline into four stages [non-cachexia (NCa), pre-cachexia (PCa), cachexia (Ca), and refractory cachexia (RCa)]. Multivariate regression, Kaplan Meier analyses, and Cox regression were conducted to evaluate associations.
UNASSIGNED: CC stage was estimated for 309 PDAC cases (156 females, 153 males). The overall prevalence of NCa, PCa, Ca, and RCa was 12.9%, 24.6%, 54.1%, and 8.4%, respectively. CC prevalence across all CC stages was highest for males and racial and ethnic minorities. Criteria differentiated NCa cases from other groups, but did not distinguish PCa from Ca. The most frequently reported symptoms included weight loss, fatigue, pain, anxiety, and depression, with pain significantly worsening over time. The greatest supportive care needs included emotional and physical domains. Males, Black people, and those with RCa had the worst OS.
UNASSIGNED: Using clinical, nutritional, and functional criteria, nearly one-quarter of the PDAC cases in our diverse, multi-institutional cohort had PCa and 62.5% had Ca or RCa at the time of diagnosis. The PCa estimate is higher than that reported in prior studies. We recommend these criteria be used to aid in CC classification, monitoring, and management of all incident PDAC cases. Findings also highlight the recommendation for continued emotional support, assistance in alleviating pain, and supportive care needs throughout the PDAC treatment journey.