The Impact of Body Mass Index Dynamics on Survival of Patients With Advanced Pancreatic Cancer Receiving Chemotherapy
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.
Key Words: Body mass index, obesity, advanced pancreatic cancer, prognosis, survival, chemotherapy
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