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

Kasenda, Benjamin; Bass, Annatina; Koeberle, Dieter; Paulweber, Bernhard; Borner, Markus; Herrmann, Richard; Jost, L.; Lohri, Andreas; Hess, Viviane

doi:10.1186/1471-2407-14-728

Cited by 43 publications

(34 citation statements)

References 28 publications

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“…Other studies have shown an association of peripheral MDSCs with age [29] and obesity [30, 31], risk factors associated with poorer outcomes in pancreatic cancer patients [32]. We were unable to correlate the frequency of MDSC in the spleen with these clinical characteristics.…”

Section: Discussionmentioning

confidence: 78%

Immunosuppressive myeloid-derived suppressor cells are increased in splenocytes from cancer patients

Jordan

Kapoor

Spongberg

et al. 2017

Cancer Immunol Immunother

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Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of myeloid cells that are increased in the peripheral blood of cancer patients and limit productive immune responses against tumors. Immunosuppressive MDSCs are well characterized in murine splenic tissue and are found at higher frequencies in spleens of tumor-bearing mice. However, no studies have yet analyzed these cells in parallel human spleens. We hypothesized that MDSCs would be increased in the spleens of human cancer patients, similar to tumor-bearing mice. We compared the frequency and function of MDSC subsets in dissociated human spleen from 16 patients with benign pancreatic cysts and 26 patients with a variety of cancers. We found that total MDSCs (Linneg CD11bpos CD33pos HLA-DRneg), granulocytic MDSCs (additional markers CD14neg CD15pos), and monocytic MDSCs (CD14pos CD15neg) were identified in human spleen. The monocytic subset was the most prominent in both spleen and peripheral blood and the granulocytic subset was expanded in the spleen relative to matched peripheral blood samples. Importantly, the frequency of CD15pos MDSCs in the spleen was increased in patients with cancer compared to patients with benign pancreatic cysts and was associated with a significantly increased risk of death and decreased overall survival. Finally, MDSCs isolated from the spleen suppressed T cell responses, demonstrating for the first time the functional capacity of human splenic MDSCs. These data suggest that the human spleen is a potential source of large quantities of cells with immunosuppressive function for future characterization and in-depth studies of human MDSCs.

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Section: Discussionmentioning

confidence: 78%

Immunosuppressive myeloid-derived suppressor cells are increased in splenocytes from cancer patients

Jordan

Kapoor

Spongberg

et al. 2017

Cancer Immunol Immunother

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“…However, the data are inconsistent for breast cancer (11) and pancreatic cancer (12, 13), and no associations have been observed in ovarian cancer (14), colorectal cancer (15), lymphoma (14), pancreatic cancer, or esophageal cancer (16). In contrast, higher BMI at diagnosis has been associated with better prognosis in acute myeloid leukemia (17), multiple myeloma (18), head and neck cancers (19), and among women with non-Hodgkins lymphoma (9).…”

Section: Introductionmentioning

confidence: 99%

Association between Body Mass Index and Cancer Survival in a Pooled Analysis of 22 Clinical Trials

Greenlee

Unger

LeBlanc

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

149

100

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BACKGROUND Data are inconsistent on the association between body mass index (BMI) at time of cancer diagnosis and prognosis. We used data from 22 clinical treatment trials to examine the association between BMI and survival across multiple cancer types and stages. METHODS Trials with ≥5 years of follow-up were selected. Patients with BMI<18.5kg/m2 were excluded. Within a disease, analyses were limited to patients on similar treatment regimens. Variable cutpoint analysis identified a BMI cutpoint that maximized differences in survival. Multivariable Cox regression analyses compared survival between patients with BMI above versus below the cutpoint, adjusting for age, race, sex, and important disease-specific clinical prognostic factors. RESULTS A total of 11,724 patients from 22 trials were identified. Fourteen analyses were performed by disease site and treatment regimen. A cutpoint of BMI=25kg/m2 maximized survival differences. No statistically significant trend across all 14 analyses was observed (mean HR=0.96, P=.06). In no cancer/treatment combination was elevated BMI associated with an increased risk of death; for some cancers there was a survival advantage for higher BMI. In sex-stratified analyses, BMI≥25kg/m2 was associated with better overall survival among men (HR=0.82; P=.003), but not women (HR=1.04; P=.86). The association persisted when sex-specific cancers were excluded, when treatment regimens were restricted to dose based on body-surface area, and when early stage cancers were excluded. CONCLUSION The association between BMI and survival is not consistent across cancer types and stages. IMPACT Our findings suggest that disease, stage, and gender specific body size recommendations for cancer survivors may be warranted.

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“…Higher BMI has been linked to shorter survival in some cancer types, such as colorectal and pancreatic cancers (Kasenda et al, 2014;Vrieling & Kampman, 2010). In contrast, other studies have reported lower mortality among overweight or mildly obese patients with colorectal cancer (CRC) (Schlesinger et al, 2014), clear cell renal cell carcinoma (RCC) (Hakimi et al, 2013) and patients with advanced gastrointestinal or lung cancer (Martin et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Visceral adiposity and cancer survival: a review of imaging studies

et al. 2016

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Although obesity is a well-known risk factor for cancer, the association between obesity and cancer survival remains controversial. This is partially due to the inability of conventional obesity measures to directly assess adiposity or adipose tissue distribution. As a metabolic organ, visceral adipose tissue (VAT) secrets a variety of cytokines and cytokine-like factors, potentially affecting cancer survival. The objective of this review was to investigate the influence of imaging-assessed VAT on cancer survival. A total of 22 studies assessing the impact of visceral adiposity on survival were included. Negative associations between VAT and survival were more frequently observed among patients with colorectal (four of six studies) and pancreatic (three of five studies) cancers, compared to higher VAT predicting longer survival in most studies of renal cell carcinoma patients (four of five studies). Methodological limitations, including unstandardised VAT measurement methods, lack of other body composition measurement (i.e. muscle mass), small sample size and heterogeneous cohort characteristics, may explain controversial findings related to the impact of VAT on cancer survival.

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

Cited by 43 publications

References 28 publications

Immunosuppressive myeloid-derived suppressor cells are increased in splenocytes from cancer patients

Immunosuppressive myeloid-derived suppressor cells are increased in splenocytes from cancer patients

Association between Body Mass Index and Cancer Survival in a Pooled Analysis of 22 Clinical Trials

Visceral adiposity and cancer survival: a review of imaging studies

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