Sarcopenia as an independent prognostic factor of reduced survival in elderly pancreatic cancer patients: A single-center experience

Introduction Sarcopenia, characterized by a loss of muscle mass and function, is highly prevalent in elderly patients with pancreatic cancer, often associated with cachexia. It significantly impacts prognosis by influencing therapeutic tolerance and survival. This study aimed to evaluate the prevalence and clinical impact of sarcopenia in elderly patients with pancreatic cancer. Methods We conducted a retrospective, single-center study of 30 patients with pancreatic cancer. Demographic, clinical, genetic, therapeutic, and outcome data were collected and analyzed using a standardized grid. Each case was discussed in a multidisciplinary team (MDT) meeting. Statistical analysis assessed the association between sarcopenia and prognosis. Results The mean age at diagnosis was 69.4 years (range: 46–90). Comorbidities included diabetes (43.3%), arterial hypertension (33.3%), and familial cancer history (33.3%). Tumor location was cephalic in 93% of cases. Disease stages were: localized (23%), locally advanced (43.3%), and metastatic (33.3%). Clinically, asthenia and abdominal pain were present in 50% of cases, jaundice in 66.6%. WHO performance status was 1 in 23.3% and 2 in 76.7%. Severe weight loss (>10 kg) occurred in 66.6% of patients. Sarcopenia was present in 60% of cases. Treatments included FOLFIRINOX (33.3%), gemcitabine-platinum salts (33.3%), gemcitabine-nimotuzumab (16.6%), and gemcitabine alone (16.6%). Median overall survival was 8 months, significantly lower in sarcopenic patients (6 vs. 11 months; p < 0.05). Discussion Our results confirm the high prevalence of sarcopenia in elderly pancreatic cancer patients. Sarcopenia is associated with impaired general condition, significant weight loss, and reduced survival. It serves as a marker of frailty and an independent unfavorable prognostic factor. Conclusion Sarcopenia is common in elderly pancreatic cancer patients and linked to poor prognosis. Systematic screening is essential to optimize therapeutic management. A multidisciplinary approach integrating nutritional support and physical activity is vital for improving outcomes.