Prognostic Value of Cognitive Impairment in Patients with Pancreatic Cancer.

[OBJECTIVE] Cognitive impairment is increasingly recognized as having a significant influence on cancer prognosis; however, its relevance in pancreatic cancer remains underexplored. This study aims to evaluate the prevalence of cognitive impairment in patients with pancreatic cancer and examine its association with overall survival (OS).

[METHODS] In this prospective study, 516 patients with newly diagnosed pancreatic cancer were enrolled. Baseline cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with cognitive impairment defined as a MoCA score < 24. Kaplan-Meier survival analysis and Cox proportional hazards models were used to examine the prognostic significance of cognitive impairment, adjusting for demographic and clinical covariates.

[RESULTS] The study cohort had a mean age of 64.30 years (standard deviation: 10.85), and 54.0% of the patients were diagnosed with stage IV pancreatic cancer. The median OS for the entire cohort was 17.18 months (95% confidence interval [CI]: 14.48 -19.88). Cognitive impairment was observed in 53.5% of patients. Median OS was significantly shorter in patients with cognitive impairment than in those without (14.71 vs. 26.80 mo, log-rank P <0.001). Cognitive impairment (hazard ratio [HR]=1.765, 95% CI: 1.206-2.583, P=0.003) and tumor stage (HR=2.582, 95% CI: 1.853-3.598, P <0.001) were independent prognostic factors for OS.

[CONCLUSIONS] Cognitive impairment is highly prevalent and independently associated with poorer OS in pancreatic cancer. These findings support routine cognitive assessments in pancreatic cancer management and highlight the need for further investigation into underlying mechanisms.