Impact of Smoking, Body Weight, Diabetes, Hypertension and Kidney Dysfunction on Survival in Pancreatic Cancer Patients—A Single Center Analysis of 2323 Patients within the Last Decade

Abstract

In addition to being risk factors for pancreatic cancer, parameters such as smoking, diabetes, or obesity might also act as potential prognostic factors for the survival of patients initially diagnosed with pancreatic cancer. By implementing one of the largest retrospective study cohorts of 2323 pancreatic adenocarcinoma (PDAC) patients treated at a single high-volume center, potential prognostic factors for survival were evaluated on the basis of 863 cases. Since parameters such as smoking, obesity, diabetes, and hypertension can cause severe chronic kidney dysfunction, the glomerular filtration rate was also considered. In the univariate analyses, albumin (p < 0.001), active smoking (p = 0.024), BMI (p = 0.018), and GFR (p = 0.002) were identified as metabolic prognostic markers for overall survival. In multivariate analyses, albumin (p < 0.001) and chronic kidney disease stage 2 (GFR < 90 mL/min/1.37 m2; p = 0.042) were identified as independent metabolic prognostic markers for survival. Smoking presented a nearly statistically significant independent prognostic factor for survival with a p-value of 0.052. In summary, low BMI, status of active smoking, and reduced kidney function at the time of diagnosis were associated with lower overall survival. No prognostic association could be observed for presence of diabetes or hypertension.

The prevalence and impact of overweight and hypertension among patients with pancreatic cancer

“…On the one hand, obesity is a well-known modifiable risk factor for PC; on the other hand, several studies confirmed that a higher BMI was correlated with longer survival in PC patients [32,[38][39][40]. These findings concur with our results, in which a higher BMI was also associated with longer survival in the group with HTN and the group with overweight/obesity.…”

“…Multidisciplinary teams might become an effective tool to facilitate collaboration between different professionals and further improve outcomes of patients with comorbidities. Similar to our study, in a single-center analysis of 2323 PC patients, HTN did not correlate with OS and showed no statistical significance in univariate analyses [32]. The study by Iede et al (2022) [33] showed that median OS in the HTN group was significantly longer than in the non-HTN group; nevertheless, the multivariate analysis failed to identify the usage of anti-hypertensive drugs as an independent prognostic factor for OS in PC patients.…”

Pancreatic Cancer Health Disparity: Pharmacologic Anthropology

“…Genetic and biological factors that influence chronic inflammation, such as variations in immune response genes, can contribute to disparities in PCa risk and outcomes. Additionally, metabolic conditions such as obesity and diabetes [103,104], which have genetic and biological underpinnings, are associated with an increased risk of PCa and may contribute to disparities. Genetic variations can impact drug metabolism, efficacy, and toxicity.…”