Impact of body composition on prognostic stratification and survival in periampullary carcinoma after pancreatoduodenectomy.

Objectives: To evaluate the prognostic impact of preoperative body composition parameters and their changes at three months post-pancreatoduodenectomy (PD) on overall survival (OS) and recurrence-free survival (RFS) in periampullary carcinoma patients. Materials and methods: This retrospective study...

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Publicado en:Abdominal Radiology Vol. 51; no. 4; pp. 1820 - 1834
Autores principales: Chen, Tao, Zhang, Danbin, Zhou, Bangguo, Cai, Shuyang, Du, Wenting, Lee, Jeong Min, Xiao, Wenbo, Bai, Xueli
Formato: Journal Article
Publicado: Springer Nature Apr2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2026
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00261-025-05180-8
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        atl: Impact of body composition on prognostic stratification and survival in periampullary carcinoma after pancreatoduodenectomy.
      aug:
        au:
          Chen, Tao
          Zhang, Danbin
          Zhou, Bangguo
          Cai, Shuyang
          Du, Wenting
          Lee, Jeong Min
          Xiao, Wenbo
          Bai, Xueli
        affil: https://ror.org/05m1p5x56 Department of Radiology, First Affiliated Hospital Zhejiang University, Hangzhou, China
      sug:
      ab: Objectives: To evaluate the prognostic impact of preoperative body composition parameters and their changes at three months post-pancreatoduodenectomy (PD) on overall survival (OS) and recurrence-free survival (RFS) in periampullary carcinoma patients. Materials and methods: This retrospective study analyzed 505 patients (294 males, mean age 62.58 ± 9.66 years; 211 females, 63.16 ± 9.89 years) who underwent PD between January 2018 and August 2022. The mean follow-up period was 37.07 ± 17.67 months, with 128 deaths (25.3%). Preoperative CT metrics included skeletal muscle index (SMI), skeletal muscle radiodensity (SMRA), intramuscular adipose tissue index (IMATI), subcutaneous adipose tissue index (SATI), and visceral adipose tissue index (VATI). Longitudinal changes were analyzed in 356 patients who underwent 3-month follow-up CT scan. Cox regression models were used to assess prognostic factors for OS and RFS. Results: In males, low SMI and high IMATI were independent predictors of worse OS (HR 2.392, 95% CI, 1.135–5.043, P = 0.022; and HR 3.310, 95% CI, 1.741–6.294, P < 0.001, respectively). In females, low SMRA was the key prognostic factor (HR 2.272, 95% CI, 1.007–5.128, P = 0.048). All parameters significantly decreased after 3 months. Among patients stratified by preoperative SMI, those with high SMI decline (≥ 8.4% loss for males, ≥ 4.5% loss for females) had worse prognoses than those with low decline (P < 0.05). Conclusions: Preoperative body composition is associated with OS in patients with periampullary carcinoma. Integrating preoperative SMI status and postoperative SMI changes provide a more nuanced prognostic stratification. Gender-specific body composition analysis may improve prognostic accuracy and postoperative management.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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