ESMO Congress 2023 | OncologyPRO

Abstract 1608P

Background

Sarcopenia and myosteatosis have been associated with a poor prognosis for certain cancers. The albumin-myosteatosis gauge (AMG) is a novel integrated measure proposed to assess myosteatosis along with serum albumin level as a surrogate of systemic inflammation. The aim of this study was to investigate the prognostic value of AMG in patients with advanced pancreatic cancer (APC).

Methods

Patients with APC treated with chemotherapy between 2013 and 2022 were evaluated. Skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) were calculated using computed tomography at the L3 level. The AMG was defined as SMD × albumin and expressed as an arbitrary unit (AU). Patients were categorized into two groups by sex-specific cut-off value according to the AMG. Univariate and multivariate Cox analyses were performed for survival analysis.

Results

A total of 196 patients were included. The median age (interquartile range) was 62 (54-67), and 128 (65.3%) were male. ECOG PS was 0/1/2 in 48%/46%/6% of the patients, respectively. At presentation, 79% of patients had metastatic disease, and 21% had locally advanced disease. With regard to AMG, 142.86 and 114.15 AU were identified as cut-off values for males and females, respectively. The patients with low AMG had significantly poorer OS than those in high AMG group (median: 8.33 vs. 12.93 months, p=0.040). In multivariable analyses, lower AMG values (HR: 1.61, 95% CI: 1.17-2.21, p=0.003), higher ECOG performance score (>0 vs 0) (HR: 1.51, 95% CI: 1.10-2.06, p=0.009) and metastatic disease (vs. locally advanced) (HR: 1.88, 95% CI: 1.27-2.79, p=0.001) were associated with decreased OS (see table).

Table: 1608P

	Multivariate analysis
Variable	HR	95%CI	p value
ECOG status (> 0 vs. 0)	1.51	1.10-2.06	0.009
Stage at diagnosis (metastatic vs locally advanced)	1.88	1.27-2.79	0.001
Sarcopenia	1.33	0.96-1.83	0.081
Albumin-myosteatosis gauge (G1-G2 vs. G3-G4)	1.61	1.17-1.21	0.003

Conclusions

This study suggests strong prognostic value for AMG in patients with APC undergoing first-line chemotherapy. Further studies are warranted to validate these findings and assess potential predictive role in guiding treatment.