Mathur Abhishek, Luberice Kenneth, Paul Harold, Franka Co, Rosemurgy Alexander
Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL, USA.
Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL, USA.
Am J Surg. 2015 Jun;209(6):969-73. doi: 10.1016/j.amjsurg.2014.12.037. Epub 2015 Mar 25.
Body mass index (BMI), a common surrogate marker for grading obesity, does not differentiate between metabolically active visceral fat and the relatively inert subcutaneous fat. We aim to determine the utility of BMI as a prognostic marker for the impact of obesity on outcomes and survival following pancreatoduodenectomy for pancreatic adenocarcinoma.
From a database of over 1,000 patients who had undergone pancreatoduodenectomy, 228 patients with a diagnosis of pancreatic adenocarcinoma were identified. Demographic data including BMI and perioperative parameters-operative time, estimated blood loss, length of stay, survival, nodal status, and American Joint Committee on Cancer stage-were obtained. Data are presented as median.
One hundred ninety-two patients had a BMI less than or equal to 29 and 36 patients had a BMI greater than or equal to 30 (24 vs. 34, P < .001). Median age was 70 and the majority of the patients (52%) were male and the 2 groups of patients did not differ in this regard. A significantly greater number of obese patients had positive nodes (69% vs. 62%, P < .05) and this was associated with a worse survival (14 vs. 18 months, P < .05).
For patients with pancreatic adenocarcinoma undergoing pancreatoduodenectomy, obesity does not impact operative complexity or length of stay but results in a shortened survival. Therefore, we conclude that BMI is an important prognostic marker that portends an abbreviated survival following pancreatoduodenectomy for pancreatic adenocarcinoma.
体重指数（BMI）是评估肥胖程度的常用替代指标，无法区分代谢活跃的内脏脂肪和相对惰性的皮下脂肪。我们旨在确定BMI作为肥胖对胰腺腺癌胰十二指肠切除术后结局和生存影响的预后指标的效用。
从超过1000例行胰十二指肠切除术患者的数据库中，识别出228例诊断为胰腺腺癌的患者。获取包括BMI及围手术期参数（手术时间、估计失血量、住院时间、生存情况、淋巴结状态和美国癌症联合委员会分期）在内的人口统计学数据。数据以中位数表示。
192例患者BMI小于或等于29，36例患者BMI大于或等于30（24对34，P < 0.001）。中位年龄为70岁，大多数患者（52%）为男性，两组患者在这方面无差异。肥胖患者中淋巴结阳性的比例显著更高（69%对62%，P < 0.05），且这与较差的生存率相关（14个月对18个月，P < 0.05）。
对于接受胰十二指肠切除术的胰腺腺癌患者，肥胖不影响手术复杂性或住院时间，但会导致生存期缩短。因此，我们得出结论，BMI是一个重要的预后指标，预示着胰腺腺癌胰十二指肠切除术后生存期缩短。
