Obesity adversely affects survival in pancreatic cancer patients

Abstract

BACKGROUND: Higher body-mass index (BMI) has been implicated as a risk factor for developing pancreatic cancer, but its effect on survival has not been thoroughly investigated. The authors assessed the association of BMI with survival in a sample of pancreatic cancer patients and used epidemiologic and clinical information to understand the contribution of diabetes and hyperglycemia. METHODS: A survival analysis using Cox proportional hazards by usual adult BMI was performed on 1861 unselected patients with pancreatic adenocarcinoma; analyses were adjusted for covariates that included clinical stage, age, and sex. Secondary analyses incorporated self-reported diabetes and fasting blood glucose in the survival model. RESULTS: BMI as a continuous variable was inversely associated with survival from pancreatic adenocarcinoma (hazard ratio [HR], 1.019 for each increased unit of BMI [kg/m 2 ], P < .001)

Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study

“…This approach has been proposed as a remedy for such situations and its incorporation into routine practice has been recommended to avoid biased estimates [17, 21, 22]. Also, the absolute number of obese and very obese patients (BMI >30) in our Swiss cohort was much lower (N = 32; 7%, Table  1) as compared to previously published US cohorts [10]. Second, we had no data on the development of BMI or onset of diabetes during therapy and follow-up.…”

“…Recently high baseline serum concentration of the tumour marker CA 19–9 has been identified as an independent negative prognostic factor in two independent cohorts of patients with advanced pancreatic cancer [8, 9]. There is some evidence that men have an increased risk of death compared to women [9], however this association was not confirmed by another group [10]. Obesity at the time of diagnosis has been reported to be associated with worse prognosis in several malignant diseases including prostate, colon, and breast cancer [11–13] – an observation with major implications given the epidemic prevalence of obesity in many regions of the world.…”

Clinical and Morphological Characteristics of Sporadic Genetically Determined Pancreatitis as Compared to Idiopathic Pancreatitis: Higher Risk of Pancreatic Cancer in CFTR Variants

“…Carrying a disease-associated mutation in the CFTR gene has been recently linked to a modest increased risk for developing pancreatic cancer [42]. Another report [43] does not support the view that CFTR mutations and the 5T allele conferred a higher risk of pancreatic cancer, although a review [44] has concluded a modest but consistent increased risk of pancreatic cancer in CF patients.…”

Influence of Obesity and Other Risk Factors on Survival Outcomes in Patients Undergoing Pancreaticoduodenectomy for Pancreatic Cancer

“…Among studies investigating obesityrelated prognosis in all stages of pancreatic cancer, 1 retrospective review of 475 patients found no difference among patients with both resectable and nonresectable diseases, 23 although other studies reported that obesity was associated with worsening clinical outcome. 10,24 In patients who have undergone curable resection for early stage pancreatic cancer, the impact of obesity again has been even more controversial. One retrospective study reviewed 306 patients undergoing pancreatic resection and found that, although obese patients were more likely to experience postoperative complications (P = 0.01), there was no significant difference seen in overall survival.…”