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This study addresses uncertainty about whether early on-treatment changes in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle index (SMI) relate to outcomes in unresectable pancreatic cancer. Methods A retrospective cohort analyzed baseline and 3-month CT scans at L3, quantifying SAT, VAT, and SMI using percent changes and landmark survival analyses. Results Preservation of SAT loss predicted lower mortality, with stronger discrimination for survival categories than VAT or SMI. Conclusion Early SAT loss aligns more closely with poor prognosis than concurrent VAT or SMI changes, supporting serial CT-based risk stratification.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/subcutaneous-adipose-tissue-loss-as-an-early-indicator-of-cancer-cachexia-in-unresectable-pancreatic-cancer/356568/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/subcutaneous-adipose-tissue-loss-as-an-early-indicator-of-cancer-cachexia-in-unresectable-pancreatic-cancer/356568.png","ImageObject",300,407,{"name":92,"@type":93},"Connor ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-24","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What question does the study investigate about unresectable pancreatic cancer prognosis?","Question",{"text":112,"@type":113},"It examines whether early on-treatment changes in SAT, VAT, and SMI are associated with prognosis in unresectable pancreatic cancer.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were SAT, VAT, and SMI measured in this research?",{"text":117,"@type":113},"SAT, VAT, and SMI were quantified using baseline and 3-month CT scans at the L3 level, and percent changes (Δ%) were calculated.",{"name":119,"@type":110,"acceptedAnswer":120},"Which body-composition change best predicted survival outcomes?",{"text":121,"@type":113},"Greater preservation of SAT (smaller SAT loss) was associated with reduced mortality risk and the best discrimination for short- vs long-term survival.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},356568,1790211604,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},687207022233,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Supportive Care in Cancer (2026) 34:395  \n[https://doi.org/10.1007/s00520-026-10614-0](https://doi.org/10.1007/s00520-026-10614-0)  \nSubcutaneous adipose tissue loss as an early indicator of cancer cachexia in unresectable pancreatic cancer  \nMariko Ohara1 · Osamu Inatomi1 · Hiroto Inoue2 · Noriaki Yamashita1 · Shuhei Shintani1 · Takayuki Imai1 · Hiroshi Matsumoto1 · Masashi Ohno1 · Hidenori Kimura2 · Atsushi Nishida1 · Takuji Iwashita1  \nReceived: 5 October 2025 / Accepted: 23 March 2026 / Published online: 1 April 2026 © The Author(s) 2026  \nAbstract  \nPurpose Body-composition indices beyond body mass index (BMI) are increasingly being investigated as prognostic cancer markers. In pancreatic cancer, the prognostic relevance of skeletal muscle and adipose tissue compartments remains uncertain, with studies yielding inconsistent findings. We examined whether early on-treatment changes in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle index (SMI) are associated with unresectable pancreatic cancer prognosis.  \nMethods This retrospective cohort study comprised patients with unresectable pancreatic cancer who received chemotherapy between 2019 and 2024. Baseline and 3-month computed tomography (CT) scans at L3 were analyzed to quantify SAT, VAT, and SMI, calculating percent changes (Δ%) . A 3-month landmark approach was applied to survival analyses. Associations with overall survival (OS) were examined using Cox models; discrimination with receiver operating characteristic curves; and survival differences using Kaplan–Meier and log-rank tests.  \nResults Sixty-nine patients were included (median age, 71 years; median OS, 12.0 months) . Greater preservation of SAT Δ% was associated with reduced mortality risk (HR per tertile step, 0.64; 95% confidence interval, 0.44–0.94), whereas VAT and SMI changes were not significant. SAT Δ% achieved the highest AUC for classifying short-vs long-term survival (0.73) compared with VAT (0.65) and SMI (0.52) . The Kaplan–Meier analysis showed significant separation between extreme SAT tertiles (p = 0.02) .  \nConclusion Early SAT loss was more strongly associated with poor prognosis than concurrent VAT or SMI changes. Serial assessment of SAT on routine CT may enhance early risk stratification in unresectable pancreatic cancer.  \nKeywords Pancreatic neoplasms · Subcutaneous fat · Sarcopenia · Prognosis  \nIntroduction  \nCancer cachexia is a multifactorial syndrome characterized by involuntary weight loss, skeletal muscle depletion, and systemic inflammation, with sarcopenia assessment being an important component in cancer prognosis evaluation [1] . Traditional definitions of sarcopenia emphasize skeletal muscle parameters such as mass, strength, and physical performance, positioning muscle loss as the hallmark  \n* Osamu Inatomi[osam@belle.shiga-med.ac.jp](osam@belle.shiga-med.ac.jp)  \n1 Department of Gastroenterology, Shiga University of Medical Science, Seta Tsukinowa, Otsu 520-2192, Japan  \n2 Department of Endoscopy, Shiga University of Medical Science, Seta Tsukinowa, Otsu, 520-2192, Japan  \nof cancer-related wasting. However, this muscle-centered view may incompletely capture early disease dynamics as muscle loss often occurs later in the cachectic process and can be influenced by confounders such as hydration status, corticosteroid use, or physical activity levels.  \nSimple anthropometric indices such as body mass index (BMI) are readily accessible in clinical practice but provide limited insight into body composition. This limitation has prompted growing recognition of adipose tissue, once considered a passive energy store, as a metabolically and endocrinologically active organ with key roles in systemic metabolism and inflammation [2, 3] . Accordingly, sarcopenic obesity, characterized by low skeletal muscle mass in combination with high BMI, has been identified as a poor prognostic factor in lung and gastrointestinal cancers [1] . These findings highlig","cbCaia9FFGxK9hFG","https://ap.wps.com/l/cbCaia9FFGxK9hFG","pdf",858030,"English","# Abstract\n# Purpose\n# Methods\n## Study design and definition\n# Results\n# Conclusion\n# Keywords\n# Introduction","[{\"question\":\"What question does the study investigate about unresectable pancreatic cancer prognosis?\",\"answer\":\"It examines whether early on-treatment changes in SAT, VAT, and SMI are associated with prognosis in unresectable pancreatic cancer.\"},{\"question\":\"How were SAT, VAT, and SMI measured in this research?\",\"answer\":\"SAT, VAT, and SMI were quantified using baseline and 3-month CT scans at the L3 level, and percent changes (Δ%) were calculated.\"},{\"question\":\"Which body-composition change best predicted survival outcomes?\",\"answer\":\"Greater preservation of SAT (smaller SAT loss) was associated with reduced mortality risk and the best discrimination for short- vs long-term survival.\"}]","Subcutaneous adipose tissue loss as an early indicator of cancer cachexia in unresectable pancreatic cancer | PDF",1790125988,23]