Association between weight loss and overall survival in patients with pancreatic cancer: a meta-analysis

Weight loss is a common symptom among patients with pancreatic cancer, often indicating tumor progression or poor nutritional status. This meta-analysis aimed to investigate the association between weight loss and overall survival in individuals with pancreatic cancer, synthesizing evidence from observational studies. A thorough search of the PubMed, Embase, and Web of Science databases was conducted up to 18 May 2025. Eligible studies must have reported quantitative associations between percent weight loss and overall survival in patients with pancreatic cancer. The adjusted hazard ratios with 95% confidence intervals (CIs) were pooled using a random-effects model to account for clinical heterogeneity. Eleven observational studies, comprising 1649 patients with pancreatic cancer were included. The pooled result showed that weight loss was significantly associated with reduced overall survival (hazard ratio: 1.55, 95% CI: 1.29-1.85). Subgroup analyses revealed stronger associations in patients aged 65 years or over (hazard ratio: 1.64, 95% CI: 1.28-2.10) and those assessed for weight loss during treatment (hazard ratio: 2.20, 95% CI: 1.68-2.89), compared with their counterparts; however, there was no clear association between weight loss and overall survival (hazard ratio: 1.27, 95% CI: 0.99-1.61) in pancreatic ductal adenocarcinoma subgroup. Weight loss serves as an independent prognostic factor for reduced overall survival in pancreatic cancer. Clinicians should prioritize nutritional assessment in patients with weight loss to inform personalized care strategies; however, further prospective studies are needed to validate these findings and elucidate underlying mechanisms.