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体质量指数和血清白蛋白对胰十二指肠切除术患者总生存的影响:一项单中心回顾性队列研究。

Effects of body mass index and serum albumin on overall survival in patients with cancer undergoing pancreaticoduodenectomy: a single-center retrospective cohort study.

机构信息

Department of General Surgery, Pancreas Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

出版信息

World J Surg Oncol. 2022 Jul 1;20(1):221. doi: 10.1186/s12957-022-02678-z.

Abstract

OBJECTIVES

We aimed to explore whether body mass index (BMI) and albumin were associated with overall survival (OS) in individuals who underwent pancreaticoduodenectomy (PD) for cancer.

METHODS

Three-hundred twenty-nine consecutive patients who underwent PD for cancer were enrolled from January 2020 to December 2020. All clinicopathological information was extracted based on medical records. The survival follow-ups were regularly performed and ended on June 30, 2021. The Kaplan-Meier survival analysis and univariate and multivariate Cox proportional-hazards models were used to assess the association of BMI and albumin with OS.

RESULTS

Of the 329 patients, 186 (56.5%) were male, and median age at admission was 65.0 (56.0-71.0) years. There were 258 patients (78.4%) with BMI < 25.0 kg/m and 89 patients (27.05%) with albumin < 35.0 g/L respectively. In overall cohort, BMI < 25.0 kg/m was associated with OS (adjusted HR = 3.516, 95% CI = 1.076-11.492, P = 0.037). In contrast, albumin < 35.0 g/L did not affect OS. Subgroup analysis showed, in patients with pancreas lesion, BMI < 25.0 kg/m had a higher risk for OS compared to BMI ≥ 25.0 kg/m (adjusted HR = 3.209, 95% CI = 0.985-10.451, P = 0.048), while albumin < 35.0 g/L was not linked to OS. In patients with lesion in ampulla of Vater, duodenum, or common bile duct, there was no significant association of BMI and albumin with OS.

CONCLUSIONS

BMI, rather than serum albumin, was associated with OS in patients who underwent PD for cancer.

摘要

目的

本研究旨在探讨体质指数(BMI)和白蛋白是否与接受胰十二指肠切除术(PD)治疗的癌症患者的总生存期(OS)相关。

方法

本研究纳入了 2020 年 1 月至 2020 年 12 月期间接受 PD 治疗的 329 例连续癌症患者。所有临床病理信息均基于病历提取。定期进行生存随访,随访截止日期为 2021 年 6 月 30 日。Kaplan-Meier 生存分析和单因素及多因素 Cox 比例风险模型用于评估 BMI 和白蛋白与 OS 的关系。

结果

在 329 例患者中,186 例(56.5%)为男性,入院时中位年龄为 65.0(56.0-71.0)岁。BMI<25.0kg/m2 的患者有 258 例(78.4%),白蛋白<35.0g/L 的患者有 89 例(27.05%)。在总队列中,BMI<25.0kg/m2 与 OS 相关(调整后的 HR=3.516,95%CI=1.076-11.492,P=0.037)。相反,白蛋白<35.0g/L 并不影响 OS。亚组分析显示,在胰腺病变患者中,BMI<25.0kg/m2 比 BMI≥25.0kg/m2 的患者 OS 风险更高(调整后的 HR=3.209,95%CI=0.985-10.451,P=0.048),而白蛋白<35.0g/L 与 OS 无关。在壶腹、十二指肠或胆总管病变患者中,BMI 和白蛋白与 OS 无显著相关性。

结论

在接受 PD 治疗的癌症患者中,BMI 而非血清白蛋白与 OS 相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ed/9248124/20baddc70f3e/12957_2022_2678_Fig1_HTML.jpg

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