Natural history of weight changes in pancreatic cancer: A longitudinal analysis.

Abstract

e24063 Background: Unintentional weight loss is common in people with pancreatic cancer and predicts poor outcomes. This study characterized temporal patterns of weight change following a pancreatic cancer diagnosis in a large, diverse patient population in a community oncology setting. Methods: Adults diagnosed with stage I–IV pancreatic cancer from 2020–2024 were identified from an internal registry. Longitudinal weights from six months prior to and 18 months after diagnosis were extracted from electronic medical records (EPIC). Among 635 eligible patients, 402 had baseline weights within one week of diagnosis. Percent weight change from diagnosis was modeled with separate pre- and post-diagnosis slopes, adjusted for age, sex, and stage, with patient-level random effects. Kaplan-Meier methods estimated length of follow-up and landmark overall survival. P<0.05 was considered statistically significant. Results: Median age was 69 (range 34-93) years; 48% were female, 71% White and non- Hispanic/Latino (98%). 52% had stage IV disease. Weight declined by 0.57% (95% CI, −0.64 to −0.49) per week before diagnosis and 0.28% (95% CI, −0.32 to −0.22) per week after diagnosis. Mean cumulative change was +14.7% (95% CI, +12.9% to +16.5%) at six months pre-diagnosis, +7.3% (95% CI, +6.5% to +8.2%) at 3 months pre-diagnosis, -3.6% (95% CI, -4.2% to -2.9%) at 3 months post-diagnosis, -7.1% (95% CI, -8.4% to -5.9%) at 6 months post-diagnosis, and -14.3% (95% CI, -16.7% to -11.9%) at 12 months post-diagnosis. Median follow-up was 19.6 months; 225 deaths (56%) occurred. One- and two-year survival rates were 0.53 and 0.34, respectively. Conclusions: Weight loss began up to six months before diagnosis and persisted afterward, averaging a 14% reduction within a year. These findings highlight the need for nutritional intervention at diagnosis and demonstrates the value of consistent and longitudinal weight management to identify at risk for future severe weight loss.