Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2017; 23(34): 6287-6293
Published online Sep 14, 2017. doi: 10.3748/wjg.v23.i34.6287
Body mass index does not affect the survival of pancreatic cancer patients
Qing-Long Jiang, Cheng-Feng Wang, Yan-Tao Tian, Huang Huang, Shui-Sheng Zhang, Dong-Bing Zhao, Jie Ma, Wei Yuan, Yue-Min Sun, Xu Che, Jian-Wei Zhang, Yun-Mian Chu, Ya-Wei Zhang, Ying-Tai Chen
Qing-Long Jiang, Cheng-Feng Wang, Yan-Tao Tian, Shui-Sheng Zhang, Dong-Bing Zhao, Jie Ma, Wei Yuan, Yue-Min Sun, Xu Che, Jian-Wei Zhang, Yun-Mian Chu, Ying-Tai Chen, Department of Pancreatic and Gastric Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Huang Huang, Ya-Wei Zhang, Department of Surgery, Yale School of Medicine, Yale Cancer Center, New Haven, CT 06511, United States
Author contributions: Jiang QL, Wang CF, Chen YT and Zhang YW designed the research; Tian YT, Huang H, Zhang SS, Zhao DB and Ma J collected the data; Yuan W, Sun YM, Che X and Zhang JW analyzed the data; Jiang QL and Chen YT wrote the paper; all authors contributed to this manuscript.
Supported by National Natural Science Foundation of China, No. 81401947; Beijing Nova Program, No. xxjh2015A090; Cancer Hospital of the Chinese Academy of Medical Sciences, No. LC2015L11.
Institutional review board statement: The study was reviewed and approved by the Cancer Hospital of the Chinese Academy of Medical Sciences.
Informed consent statement: All study participants provided informed written consent prior to study enrolment.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ying-Tai Chen, MD, PhD, Department of Pancreatic and Gastric Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. yingtai.chen@yale.edu
Telephone: +86-10-87787120 Fax: +86-10-87787123
Received: February 22, 2017
Peer-review started: February 24, 2017
First decision: April 7, 2017
Revised: May 5, 2017
Accepted: July 12, 2017
Article in press: July 12, 2017
Published online: September 14, 2017
Processing time: 203 Days and 16 Hours
Abstract
AIM

To evaluate the association of body mass index (BMI) with the overall survival of pancreatic ductal adenocarcinoma (PDAC) patients.

METHODS

A retrospective analysis of PDAC patients diagnosed in the National Cancer Center of China between January 1999 and December 2014 was performed. These patients were categorized into four BMI groups (< 18.5, 18.5-22.9, 23-27.4 and ≥ 27.5 kg/m2). χ2 tests for comparison of the proportions of categorical variables, and Student’s t-test or Mann-Whitney test for continuous variables were employed. Survival analysis was performed with the Kaplan-Meyer method. Their HRs of mortality and 95%CIs were estimated using the Cox proportional hazards model.

RESULTS

With a median age of 59.6 years (range: 22.5-84.6 years), in total 1783 PDAC patients were enrolled in this study. Their mean usual BMI was 24.19 ± 3.53 for the whole cohort. More than half of the patients (59.3%) experienced weight loss during the disease onset and progression. Compared with healthy-weight individuals, newly diagnosed patients who were overweight or obese had more severe weight loss during their disease onset and progression (P < 0.001). Individuals who were overweight or obese were associated with positive smoking history (P < 0.001). A significant difference in comorbidity of diabetes (P = 0.044) and coronary artery disease (P < 0.001) was identified between high BMI and normal-weight patients. After a median follow-up of 8 mo, the survival analysis showed no association between BMI and the overall survival (P = 0.90, n = 1783). When we stratified the whole cohort by pancreatic cancer stage, no statistically significant association between BMI and overall survival was found for resectable (P = 0.99, n = 217), unresectable locally advanced (P = 0.90, n = 316) and metastatic patients (P = 0.88, n = 1250), respectively. The results did not change when we used the BMI at diagnosis.

CONCLUSION

Our results showed no significance of BMI for the overall survival of PDAC patients.

Keywords: Body mass index; Pancreatic cancer; Overweight; Smoking history; Survival analysis

Core tip: It remains controversial whether body mass index (BMI) influences the prognosis of pancreatic cancer. The strengths of this study included a large quantity of patients and the accurate BMI categorization according the Asian criterion. To the best of our knowledge, it is the largest study in Asia to evaluate the prognostic role of BMI on the overall survival of pancreatic cancer patients. Our results showed no significant influence of BMI on the overall survival of pancreatic ductal adenocarcinoma patients and are consistent with those of many other studies.