Sex-specific trajectories of muscle mass and steatotic liver disease after total pancreatectomy: a 10-year follow-up study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: Total pancreatectomy (TP) is an invasive surgery, resulting in pancreatic endocrine and exocrine dysfunction. With increasing indications for pancreatic neoplasms, including pancreatic ductal adenocarcinoma (PDAC), understanding long-term metabolic adaptation after TP is essential for survivorship care. Methods: We retrospectively analyzed 160 TP cases at Tohoku University Hospital between 2003 and 2024 and evaluated the prognosis. A subset of 20 long-term survivors (>10 years) underwent longitudinal assessment of nutritional parameters, body mass index (BMI), skeletal muscle index (SMI), and steatotic liver disease (SLD) preoperatively and at 3 to 6 months, 1, 5, and 10 years postoperatively. Results: PDAC patients ( n = 87) had significantly worse survival than non-PDAC patients ( n = 73) (10-year survival: 16.2% vs 70.7%; hazard ratio (HR), 6.92; P < .001). Serum albumin recovered within 3 to 6 months and remained stable for 10 years. BMI recovered in both sexes by 5 years, but muscle mass showed a striking sex disparity. Males regained preoperative SMI, while females suffered persistent loss (35.5–30.9 cm 2 /m 2 at 10 years). The new-onset SLD occurred far more frequently in females (37.5% at 3–6 months; 55.6% at 1 year) than males (0%–11.1%). Notably, the dramatic reduction of BMI and SMI was more frequently associated with the development of SLD after TP in females than in males. Conclusions: This is a pioneering study to describe the sex-specific long-term metabolic changes after TP. Females experienced persistent muscle loss and new-onset SLD after TP, highlighting the need for sex-specific long-term follow-up to improve quality of life and outcomes.
Source: Journal of Pancreatology
Institutions: Tohoku University, Yamagata University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7128816804