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

BACKGROUND: Obesity is a risk factor for developing pancreatic cancer. We investigated the impact of obesity on survival in patients diagnosed with locally advanced or metastatic pancreatic cancer. METHODS: In a multicentre, retrospective study, we included all patients with advanced or metastatic p...

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Autores principales: Kasenda, Benjamin, Bass, Annatina, Koeberle, Dieter, Pestalozzi, Bernhard, Borner, Markus, Herrmann, Richard, Jost, Lorenz, Lohri, Andreas, Hess, Viviane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242603/
https://www.ncbi.nlm.nih.gov/pubmed/25266049
http://dx.doi.org/10.1186/1471-2407-14-728
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author Kasenda, Benjamin
Bass, Annatina
Koeberle, Dieter
Pestalozzi, Bernhard
Borner, Markus
Herrmann, Richard
Jost, Lorenz
Lohri, Andreas
Hess, Viviane
author_facet Kasenda, Benjamin
Bass, Annatina
Koeberle, Dieter
Pestalozzi, Bernhard
Borner, Markus
Herrmann, Richard
Jost, Lorenz
Lohri, Andreas
Hess, Viviane
author_sort Kasenda, Benjamin
collection PubMed
description BACKGROUND: Obesity is a risk factor for developing pancreatic cancer. We investigated the impact of obesity on survival in patients diagnosed with locally advanced or metastatic pancreatic cancer. METHODS: In a multicentre, retrospective study, we included all patients with advanced or metastatic pancreatic cancer treated at four Swiss hospitals between 1994 and 2004. We categorized patients into four body mass index (BMI) groups (<18.5, 18.5 – 25, ≥ 25 – 29, ≥30 kg/m(2)) and used multivariable Cox regression to investigate the impact of BMI on survival. Missing data were handled using multiple imputations. RESULTS: 483 patients were included. Median age was 66 years (range 59–74), 47% were female, 82% had stage IV disease, 72% had an ECOG below 2, and 84% were treated with gemcitabine-based first-line chemotherapy. After a median follow-up of 8.5 months, 6 and 12-month survival probabilities of the whole cohort were 67% (95% CI 63% - 71%) and 37% (95% CI 33% - 42%), respectively. Unadjusted 12-month survival rates in each BMI group were: 48% (95% CI 33% - 62%), 42% (95% CI 36% - 48%), 30% (95% CI 22% - 38%), and 11% (95% CI 4% - 24%), respectively. In multivariable analysis, increasing BMI (HR 1.22, 95% CI 1.04 – 1.41, p = 0.012) and CA 19–9 (HR 1.07, 95% CI 1.02 – 1.11, p = 0.003) were significantly associated with worse survival prognosis. Patients with a good clinical performance status (ECOG < 2) had a better prognosis (HR 0.76, 95% CI 0.65 – 0.96, p = 0.019). CONCLUSIONS: Obese patients diagnosed with advanced pancreatic cancers have a worse prognosis compared to non-obese patients. BMI should be considered for risk stratification in future clinical trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2407-14-728) contains supplementary material, which is available to authorized users.
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spelling pubmed-42426032014-11-25 Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study Kasenda, Benjamin Bass, Annatina Koeberle, Dieter Pestalozzi, Bernhard Borner, Markus Herrmann, Richard Jost, Lorenz Lohri, Andreas Hess, Viviane BMC Cancer Research Article BACKGROUND: Obesity is a risk factor for developing pancreatic cancer. We investigated the impact of obesity on survival in patients diagnosed with locally advanced or metastatic pancreatic cancer. METHODS: In a multicentre, retrospective study, we included all patients with advanced or metastatic pancreatic cancer treated at four Swiss hospitals between 1994 and 2004. We categorized patients into four body mass index (BMI) groups (<18.5, 18.5 – 25, ≥ 25 – 29, ≥30 kg/m(2)) and used multivariable Cox regression to investigate the impact of BMI on survival. Missing data were handled using multiple imputations. RESULTS: 483 patients were included. Median age was 66 years (range 59–74), 47% were female, 82% had stage IV disease, 72% had an ECOG below 2, and 84% were treated with gemcitabine-based first-line chemotherapy. After a median follow-up of 8.5 months, 6 and 12-month survival probabilities of the whole cohort were 67% (95% CI 63% - 71%) and 37% (95% CI 33% - 42%), respectively. Unadjusted 12-month survival rates in each BMI group were: 48% (95% CI 33% - 62%), 42% (95% CI 36% - 48%), 30% (95% CI 22% - 38%), and 11% (95% CI 4% - 24%), respectively. In multivariable analysis, increasing BMI (HR 1.22, 95% CI 1.04 – 1.41, p = 0.012) and CA 19–9 (HR 1.07, 95% CI 1.02 – 1.11, p = 0.003) were significantly associated with worse survival prognosis. Patients with a good clinical performance status (ECOG < 2) had a better prognosis (HR 0.76, 95% CI 0.65 – 0.96, p = 0.019). CONCLUSIONS: Obese patients diagnosed with advanced pancreatic cancers have a worse prognosis compared to non-obese patients. BMI should be considered for risk stratification in future clinical trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2407-14-728) contains supplementary material, which is available to authorized users. BioMed Central 2014-09-29 /pmc/articles/PMC4242603/ /pubmed/25266049 http://dx.doi.org/10.1186/1471-2407-14-728 Text en © Kasenda et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kasenda, Benjamin
Bass, Annatina
Koeberle, Dieter
Pestalozzi, Bernhard
Borner, Markus
Herrmann, Richard
Jost, Lorenz
Lohri, Andreas
Hess, Viviane
Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study
title Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study
title_full Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study
title_fullStr Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study
title_full_unstemmed Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study
title_short Survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study
title_sort survival in overweight patients with advanced pancreatic carcinoma: a multicentre cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242603/
https://www.ncbi.nlm.nih.gov/pubmed/25266049
http://dx.doi.org/10.1186/1471-2407-14-728
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