Department of Pancreatic and Gastric Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Surgery, Yale School of Medicine, Yale Cancer Center, New Haven, CT 06511, United States.
World J Gastroenterol. 2017 Sep 14;23(34):6287-6293. doi: 10.3748/wjg.v23.i34.6287.
To evaluate the association of body mass index (BMI) with the overall survival of pancreatic ductal adenocarcinoma (PDAC) patients.
A retrospective analysis of PDAC patients diagnosed in the National Cancer Center of China between January 1999 and December 2014 was performed. These patients were categorized into four BMI groups (< 18.5, 18.5-22.9, 23-27.4 and ≥ 27.5 kg/m). tests for comparison of the proportions of categorical variables, and Student's -test or Mann-Whitney test for continuous variables were employed. Survival analysis was performed with the Kaplan-Meyer method. Their HRs of mortality and 95%CIs were estimated using the Cox proportional hazards model.
With a median age of 59.6 years (range: 22.5-84.6 years), in total 1783 PDAC patients were enrolled in this study. Their mean usual BMI was 24.19 ± 3.53 for the whole cohort. More than half of the patients (59.3%) experienced weight loss during the disease onset and progression. Compared with healthy-weight individuals, newly diagnosed patients who were overweight or obese had more severe weight loss during their disease onset and progression ( < 0.001). Individuals who were overweight or obese were associated with positive smoking history ( < 0.001). A significant difference in comorbidity of diabetes ( = 0.044) and coronary artery disease ( < 0.001) was identified between high BMI and normal-weight patients. After a median follow-up of 8 mo, the survival analysis showed no association between BMI and the overall survival ( = 0.90, = 1783). When we stratified the whole cohort by pancreatic cancer stage, no statistically significant association between BMI and overall survival was found for resectable ( = 0.99, = 217), unresectable locally advanced ( = 0.90, = 316) and metastatic patients ( = 0.88, = 1250), respectively. The results did not change when we used the BMI at diagnosis.
Our results showed no significance of BMI for the overall survival of PDAC patients.
评估体重指数（BMI）与胰腺导管腺癌（PDAC）患者总生存率的相关性。
对 1999 年 1 月至 2014 年 12 月在中国国家癌症中心诊断的 PDAC 患者进行回顾性分析。这些患者分为四组 BMI 组（<18.5、18.5-22.9、23-27.4 和≥27.5kg/m）。采用检验比较分类变量的比例，采用学生 t 检验或曼-惠特尼检验比较连续变量。采用 Kaplan-Meier 法进行生存分析。采用 Cox 比例风险模型估计死亡率的 HR 及其 95%CI。
本研究共纳入 1783 例 PDAC 患者，中位年龄 59.6 岁（范围：22.5-84.6 岁）。全队列患者平均惯用 BMI 为 24.19 ± 3.53。超过一半的患者（59.3%）在疾病发病和进展过程中出现体重减轻。与体重正常的个体相比，新诊断为超重或肥胖的患者在疾病发病和进展过程中体重减轻更为严重（<0.001）。超重或肥胖个体与吸烟史阳性相关（<0.001）。高 BMI 患者与正常体重患者的糖尿病（=0.044）和冠心病（<0.001）合并症存在显著差异。中位随访 8 个月后，生存分析显示 BMI 与总体生存率之间无相关性（=0.90，=1783）。当我们按胰腺癌分期对整个队列进行分层时，可切除（=0.99，=217）、不可切除局部进展（=0.90，=316）和转移性患者（=0.88，=1250）的 BMI 与总体生存率之间无统计学显著相关性。当我们使用诊断时的 BMI 时，结果没有改变。
我们的结果表明，BMI 对 PDAC 患者的总体生存率无显著意义。
