Journal Article

DKFZ-2026-01779

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Prognostic host phenotypes based on body composition and systemic inflammation predict survival in patients with resected pancreatic and periampullary cancer.

Hildebrand, N. D. ; van Dijk, D. P. J. ; Puik, J. R. ; Henry, A. C. ; Andel, P. ; Dekker, E. N. ; Michiels, N. ; Brandts, L. ; Brecheisen, R. ; Wee, L. ; Festen, S. ; Bosscha, K. ; Schreinemakers, J. M. J. ; Wit, F. ; van der Kolk, M. B. ; Mieog, J. S. D. ; Liem, M. S. L. ; Nieuwenhuijs, V. B. ; de Hingh, I. H. J. T. ; de Vos-Geelen, J. ; Siveke, J. T.DKFZ* ; Klaase, J. M. ; de Meijer, V. E. ; de Haas, R. J. ; Groot Koerkamp, B. ; Zonderhuis, B. M. ; Kazemier, G. ; Besselink, M. G. ; Molenaar, I. Q. ; Daamen, L. A. ; den Dulk, M. ; Rensen, S. S. ; van Santvoort, H. C. ; Olde Damink, S. W. M.DKFZ* ; Group, D. P. C. (Collaboration Author)

2026
Elsevier Amsterdam [u.a.]

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.

Keyword(s): Body composition ; Pancreatic cancer ; Periampullary cancer ; Survival

Note: #DKTKZFB26#

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Essen/Düsseldorf (ED01)
2. DKTK ED Translationale Onkologie Solider Tumore (ED04)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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