Title

Obesity adversely affects survival in pancreatic cancer patients

Document Type

Journal Article

Publication Date

11-1-2010

Journal

Cancer

Volume

116

Issue

21

DOI

10.1002/cncr.25465

Keywords

Diabetes; Hyperglycemia; Obesity; Pancreatic neoplasms; Prognosis

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/m2], P <.001) after adjustment for age, stage, and sex. In analysis by National Institutes of Health BMI category, BMIs of 30 to 34.99 kg/m2 (HR, 1.14; 95% confidence interval [CI], 0.98-1.33), 35 to 39.99 kg/m2 (HR 1.32, 95% CI 1.08-1.62), and ≥40 (HR 1.60, 95% CI 1.26-2.04) were associated with decreased survival compared with normal BMI of 18.5 to 24.99 kg/m 2 (overall trend test P <.001). Fasting blood glucose and diabetes did not affect the results. CONCLUSIONS: Higher BMI is associated with decreased survival in pancreatic cancer. Although the mechanism of this association remains undetermined, diabetes and hyperglycemia do not appear to account for the observed association. © 2010 American Cancer Society.

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