Prognostic host phenotypes based on body composition and systemic inflammation predict survival in patients with resected pancreatic and periampullary cancer.

Authors

Nicole D Hildebrand, David P J van Dijk, Jisce R Puik, Anne Claire Henry, Paul Andel, Esther N Dekker, Nynke Michiels, Lloyd Brandts, Ralph Brecheisen, Leonard Wee, Sebastiaan Festen, Koop Bosscha, Jennifer M J Schreinemakers, Fennie Wit, Marion B van der Kolk, J Sven D Mieog, Mike S L Liem, Vincent B Nieuwenhuijs, Ignace H J T de Hingh, Judith de Vos-Geelen, Jens T Siveke, Joost M Klaase, Vincent E de Meijer, Robbert J de Haas, Bas Groot Koerkamp, Babs M Zonderhuis, Geert Kazemier, Marc G Besselink, I Quintus Molenaar, Lois A Daamen, Marcel den Dulk, Sander S Rensen, Hjalmar C van Santvoort, Steven W M Olde Damink, Dutch Pancreatic Cancer Group (DPCG)

Published in

European journal of cancer (Oxford, England : 1990). Volume 245. Pages 116933. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

Most present-day survival-models of patients with cancer do not account for tumor-host interactions. We hypothesized that host phenotypes based on systemic inflammation and body composition are prognostic of overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC).
We performed a post-hoc analysis of the nationwide PORSCH-trial, including all patients undergoing pancreatoduodenectomy for PDAC. Primary outcome was OS. Body composition analysis was performed using automatic segmentation (Mosamatic™) of preoperative abdominal computed tomography scans. Low muscle mass and myosteatosis were defined using log-rank stratification of sex-standardized Z-values of skeletal muscle index and radiation attenuation, respectively. Patients were clustered in eight host phenotypes based on combinations of adverse host factors: [1] low muscle mass, [2] myosteatosis, [3] systemic inflammation (C-reactive protein >6mg/L). Their association with OS was tested using multivariable-adjusted Cox-proportional hazard-analysis. Distinct combinations of adverse host factors were stratified into low-, intermediate-, and high-risk phenotypes according to k-means clustering based on log hazard-ratio's.
549 patients were included. The high-risk phenotype, characterized by the presence of all adverse host factors, showed lower median OS than intermediate ([1], [2], [1 +2], [1 +3], [2 +3]) and low-risk ([3]; none) phenotypes (13.0 months [95%CI 11.4-19.3] vs. 21.9 months [95%CI 19.3-24.7] vs. 35.2 months [95%CI 29.2-45.3], respectively; p < 0.001). In multivariable analysis, host phenotypes were associated with OS (adjusted [a]HR 1.39 [95%CI 1.08-1.80, p = 0.01; aHR 2.10 [95%CI 1.53-2.88], p < 0.01, for intermediate- and high-risk respectively), independent of tumor stage.
Host phenotypes based on body composition and systemic inflammation predict OS independent of tumor stage in patients with resected PDAC, underscoring the importance of tumor-host interactions for clinical survival prediction.

PMID:
42447512
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.