Younak Choi1, Tae-Yong Kim1, Kyung-hun Lee2, Sae-Won Han2, Do-Youn Oh3, Seock-Ah Im2, Tae-You Kim2, Yung-Jue Bang2. 1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: ohdoyoun@snu.ac.kr.
Abstract
CONTEXT: High body mass index (BMI) is linked to an increased risk of developing pancreatic cancer (PC). However, in patients with advanced PC (APC), especially those receiving palliative chemotherapy, the impact of BMI on survival has not been investigated fully. OBJECTIVES: To assess changes in BMI during the course of APC and their impact on patient survival, specifically for those receiving palliative chemotherapy. METHODS: Consecutive patients with APC, all of whom were treated with palliative chemotherapy, were enrolled during 2003-2010. Clinical characteristics and prognoses were analyzed. RESULTS: A total of 425 patients participated (median age, 60.1 years). At diagnosis of APC, patients' BMI distribution of patients was as follow: <18.5 (45, 10.6%); 18.5-19.9 (67, 15.8%); 20.0-22.4 (156, 36.7%); 22.5-24.9 (107, 25.2%); 25.0-29.9 (49, 11.5%); and ≥ 30.0 (1, 0.2%). Median overall survival (OS) was 8.1 months (95% confidence interval 7.2, 9.1). Precancer BMI and baseline BMI (at diagnosis) had no impact on OS. Weight loss at diagnosis (precancer weight minus weight at diagnosis) and weight loss during first-line chemotherapy (both stipulated as BMI change ≥ 1) were associated with shortened OS (hazard ratio, 1.300; P = 0.012 and hazard ratio, 1.367; P = 0.010, respectively). CONCLUSION: In patients with APC undergoing palliative chemotherapy, decreases in BMI at APC diagnosis and during chemotherapy are more hazardous for OS than precancer BMI or baseline BMI (at diagnosis) as absolute values. Further studies are needed to validate this finding and investigate strategies to maintain BMI during chemotherapy in this setting.
CONTEXT: High body mass index (BMI) is linked to an increased risk of developing pancreatic cancer (PC). However, in patients with advanced PC (APC), especially those receiving palliative chemotherapy, the impact of BMI on survival has not been investigated fully. OBJECTIVES: To assess changes in BMI during the course of APC and their impact on patient survival, specifically for those receiving palliative chemotherapy. METHODS: Consecutive patients with APC, all of whom were treated with palliative chemotherapy, were enrolled during 2003-2010. Clinical characteristics and prognoses were analyzed. RESULTS: A total of 425 patients participated (median age, 60.1 years). At diagnosis of APC, patients' BMI distribution of patients was as follow: <18.5 (45, 10.6%); 18.5-19.9 (67, 15.8%); 20.0-22.4 (156, 36.7%); 22.5-24.9 (107, 25.2%); 25.0-29.9 (49, 11.5%); and ≥ 30.0 (1, 0.2%). Median overall survival (OS) was 8.1 months (95% confidence interval 7.2, 9.1). Precancer BMI and baseline BMI (at diagnosis) had no impact on OS. Weight loss at diagnosis (precancer weight minus weight at diagnosis) and weight loss during first-line chemotherapy (both stipulated as BMI change ≥ 1) were associated with shortened OS (hazard ratio, 1.300; P = 0.012 and hazard ratio, 1.367; P = 0.010, respectively). CONCLUSION: In patients with APC undergoing palliative chemotherapy, decreases in BMI at APC diagnosis and during chemotherapy are more hazardous for OS than precancer BMI or baseline BMI (at diagnosis) as absolute values. Further studies are needed to validate this finding and investigate strategies to maintain BMI during chemotherapy in this setting.
Authors: Heather Greenlee; Joseph M Unger; Michael LeBlanc; Scott Ramsey; Dawn L Hershman Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-12-16 Impact factor: 4.254
Authors: Larissa L Fujii-Lau; William R Bamlet; Jason S Eldrige; Suresh T Chari; Ferga C Gleeson; Barham K Abu Dayyeh; Jonathan E Clain; Randall K Pearson; Bret T Petersen; Elizabeth Rajan; Mark D Topazian; Santhi S Vege; Kenneth K Wang; Maurits J Wiersema; Michael J Levy Journal: Gastrointest Endosc Date: 2015-03-20 Impact factor: 9.427
Authors: William H Jin; Eric A Mellon; Jessica M Frakes; Gilbert Z Murimwa; Pamela J Hodul; Jose M Pimiento; Mokenge P Malafa; Sarah E Hoffe Journal: J Gastrointest Oncol Date: 2018-02
Authors: Lydia G M van der Geest; Nadia Haj Mohammad; Marc G H Besselink; Valery E P P Lemmens; Johanneke E A Portielje; Hanneke W M van Laarhoven; J Hanneke W Wilmink Journal: Cancer Med Date: 2017-10-16 Impact factor: 4.452