TY - JOUR
T1 - Intra-abdominal Fat Predicts Survival in Pancreatic Cancer
AU - Balentine, Courtney J.
AU - Enriquez, Jose
AU - Fisher, William
AU - Hodges, Sally
AU - Bansal, Vivek
AU - Sansgiry, Shubhada
AU - Petersen, Nancy J.
AU - Berger, David H.
N1 - Funding Information:
This work was supported in part by the Houston VA HSR&D Center of Excellence (HFP90-020). C.J.Balentine(*).J.Enriquez.W.Fisher.S.Hodges. D. H. Berger Michael E DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA e-mail: cb131098@bcm.tmc.edu
PY - 2010
Y1 - 2010
N2 - Background: Body mass index (BMI) has proven unreliable in predicting survival following pancreaticoduodenectomy for cancer. While measures of intra-abdominal fat correlate with medical and postoperative complications of obesity, the impact of intra-abdominal fat on pancreatic cancer survival is uncertain. We hypothesized that the quantity of intra-abdominal fat would predict survival following resection of pancreatic cancer. Methods: Preoperative CT imaging was used to measure intra-abdominal fat. Cox regression analyses were used to identify independent predictors of survival. Results: Sixty-one patients from 2000-2009 underwent pancreaticoduodenectomy for exocrine pancreatic adenocarcinoma. After adjusting for age and perineural invasion status, preoperative BMI did not predict overall survival (p < 0.827). Unlike BMI, quartile of intra-abdominal fat predicted survival. Relative to patients with the least intra-abdominal fat (lowest quartile), those with more intra-abdominal fat demonstrated worse overall survival, but in a non-linear fashion. Individuals in the second quartile showed a fourfold increase in likelihood of death (HR 4.018, 95% CI 1.099-14.687, p < 0.035) relative to the lowest quartile. Patients in the third (HR 2.124, 95% CI 0.278-16.222, p < 0.468) and fourth quartile (HR 1.354, 95% CI 0.296-6. 190, p < 0.696) also showed greater risk of death. Conclusions: Measuring intra-abdominal fat identifies a subset of patients with worse prognosis in pancreatic cancer.
AB - Background: Body mass index (BMI) has proven unreliable in predicting survival following pancreaticoduodenectomy for cancer. While measures of intra-abdominal fat correlate with medical and postoperative complications of obesity, the impact of intra-abdominal fat on pancreatic cancer survival is uncertain. We hypothesized that the quantity of intra-abdominal fat would predict survival following resection of pancreatic cancer. Methods: Preoperative CT imaging was used to measure intra-abdominal fat. Cox regression analyses were used to identify independent predictors of survival. Results: Sixty-one patients from 2000-2009 underwent pancreaticoduodenectomy for exocrine pancreatic adenocarcinoma. After adjusting for age and perineural invasion status, preoperative BMI did not predict overall survival (p < 0.827). Unlike BMI, quartile of intra-abdominal fat predicted survival. Relative to patients with the least intra-abdominal fat (lowest quartile), those with more intra-abdominal fat demonstrated worse overall survival, but in a non-linear fashion. Individuals in the second quartile showed a fourfold increase in likelihood of death (HR 4.018, 95% CI 1.099-14.687, p < 0.035) relative to the lowest quartile. Patients in the third (HR 2.124, 95% CI 0.278-16.222, p < 0.468) and fourth quartile (HR 1.354, 95% CI 0.296-6. 190, p < 0.696) also showed greater risk of death. Conclusions: Measuring intra-abdominal fat identifies a subset of patients with worse prognosis in pancreatic cancer.
KW - Obesity
KW - Pancreaticoduodenectomy
KW - Survival
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U2 - 10.1007/s11605-010-1297-5
DO - 10.1007/s11605-010-1297-5
M3 - Article
C2 - 20725799
AN - SCOPUS:77958493008
SN - 1091-255X
VL - 14
SP - 1832
EP - 1837
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 11
ER -