Dataset Information

Predictors of Pancreatic Cancer-Associated Weight Loss and Nutritional Interventions.

ABSTRACT: OBJECTIVES:Pancreatic ductal adenocarcinoma (PDAC) is often accompanied by weight loss. We sought to characterize factors associated with weight loss and observed nutritional interventions, as well as define the effect of weight loss on survival. METHODS:Consecutive subjects diagnosed with PDAC (N = 123) were retrospectively evaluated. Univariate analysis was used to compare subjects with and without substantial (>5%) weight loss. Multivariate logistic regression was performed to identify factors associated with weight loss, and survival analyses were performed using Kaplan-Meier curves and Cox survival models. RESULTS:Substantial weight loss at diagnosis was present in 71.5% of subjects and was independently associated with higher baseline body mass index, longer symptom duration, and increased tumor size. Recommendations for nutrition consultation and pancreatic enzyme replacement therapy occurred in 27.6% and 36.9% of subjects, respectively. Weight loss (>5%) was not associated with worse survival on multivariate analysis (hazard ratio, 1.32; 95% confidence interval, 0.76-2.30), unless a higher threshold (>10%) was used (hazard ratio, 1.77; 95% confidence interval, 1.09-2.87). CONCLUSIONS:Despite the high prevalence of weight loss at PDAC diagnosis, there are low observed rates of nutritional interventions. Weight loss based on current criteria for cancer cachexia is not associated with poor survival in PDAC.

SUBMITTER: Nemer L

PROVIDER: S-EPMC5679236 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Predictors of Pancreatic Cancer-Associated Weight Loss and Nutritional Interventions.

Nemer Laura L Krishna Somashekar G SG Shah Zarine K ZK Conwell Darwin L DL Cruz-Monserrate Zobeida Z Dillhoff Mary M Guttridge Denis C DC Hinton Alice A Manilchuk Andrei A Pawlik Timothy M TM Schmidt Carl R CR Talbert Erin E EE Bekaii-Saab Tanios T Hart Phil A PA

Pancreas 20171001 9

<h4>Objectives</h4>Pancreatic ductal adenocarcinoma (PDAC) is often accompanied by weight loss. We sought to characterize factors associated with weight loss and observed nutritional interventions, as well as define the effect of weight loss on survival.<h4>Methods</h4>Consecutive subjects diagnosed with PDAC (N = 123) were retrospectively evaluated. Univariate analysis was used to compare subjects with and without substantial (>5%) weight loss. Multivariate logistic regression was performed to ...[more]

PMID: 28902785

Similar Datasets

Project description:PURPOSE:Obesity and weight gain are associated with comorbidities including a higher risk of tumor recurrence and cancer-related deaths among breast cancer (BC) survivors; however, the underlying mechanisms linking obesity and cancer are poorly understood. Given the lack of clinically validated BC biomarkers, obesity and weight-loss studies utilize serum biomarkers as the intermediary outcomes of tumor recurrence. Studies have indicated microRNAs (miRNA)s are reliable biomarkers for cancer. We hypothesized that miRNA expression correlates with obesity and weight loss amongst BC survivors. This would yield insight into the biological pathways by which this association occurs, enabling more precise development of therapeutics. PATIENTS AND METHODS:We correlated baseline body mass index (BMI) with serum miRNA expression in 121 BC survivors enrolled in the Hormones and Physical Exercise (HOPE) trial. We then analyzed expression of the 35 most abundant miRNAs from HOPE in a six-month randomized controlled weight-loss trial (Lifestyle, Exercise, and Nutrition; LEAN) in 100 BC survivors. Ingenuity pathway analysis (IPA) software was used to identify biological pathway targets of the BMI-associated and intervention-responsive miRNAs using predictive biomarkers. RESULTS:Pearson correlations in HOPE identified eight miRNAs associated with BMI, including miR-191-5p (r?=?- 0.22, p?=?0.016) and miR-122-5p (r?=?0.25, p?=?0.0048). In the LEAN validation study, levels of miR-191-5p significantly increased during the six-month intervention (p?=?0.082). Ingenuity Pathway Analysis identified "Estrogen-mediated S-phase entry" (HOPE p?=?0.003; LEAN p?<?0.001) and "Molecular mechanisms of cancer" (HOPE p?=?0.02; LEAN p?<?0.001) as the top canonical pathways that significantly correlated with BMI-associated and intervention-responsive miRNAs and contain obesity and cancer-relevant genes including the E2F family of transcription factors and CCND1, which have been implicated in sporadic BC. CONCLUSION:While the association between obesity and BC recurrence and mortality has been demonstrated in the literature, mechanisms underlying the link between weight gain and cancer are unclear. Using two independent clinical trials, we identified novel miRNAs associative to BMI and weight loss that contribute to the development of cancer. Predictive modeling of miRNA targets identified multiple canonical pathways associated with cancer, highlighting potential mechanisms explaining the link between BMI and increased cancer risk.

Dataset Information

Predictors of Pancreatic Cancer-Associated Weight Loss and Nutritional Interventions.

Publications

Predictors of Pancreatic Cancer-Associated Weight Loss and Nutritional Interventions.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets