Higher body mass index indicated better overall survival in pancreatic ductal adenocarcinoma patients: a real-world study of 2010 patients

Ningzhen Fu; Yu Jiang; Kai Qin; Hao Chen; Xiaxing Deng; Baiyong Shen

doi:10.1186/s12885-021-09056-0

Higher body mass index indicated better overall survival in pancreatic ductal adenocarcinoma patients: a real-world study of 2010 patients

BMC Cancer. 2021 Dec 9;21(1):1318. doi: 10.1186/s12885-021-09056-0.

Authors

Ningzhen Fu^#^{1

2

3

4}, Yu Jiang^#^{1

2

3

4}, Kai Qin^{1

2

3

4}, Hao Chen^{1

2

3

4}, Xiaxing Deng^{5

6

7

8}, Baiyong Shen^{9

10

11

12}

Affiliations

¹ Department of General Surgery, Pancreatic Disease Center, Shanghai Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, No.197 Ruijin Er Road, Shanghai, 200025, China.
² Research Institute of Pancreatic Diseases, Shanghai Jiao Tong University School of Medicine, No.197 Ruijin Er Road, Shanghai, 200025, China.
³ State Key Laboratory of Oncogenes and Related Genes, No.197 Ruijin Er Road, Shanghai, 200025, China.
⁴ Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁵ Department of General Surgery, Pancreatic Disease Center, Shanghai Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, No.197 Ruijin Er Road, Shanghai, 200025, China. [email protected].
⁶ Research Institute of Pancreatic Diseases, Shanghai Jiao Tong University School of Medicine, No.197 Ruijin Er Road, Shanghai, 200025, China. [email protected].
⁷ State Key Laboratory of Oncogenes and Related Genes, No.197 Ruijin Er Road, Shanghai, 200025, China. [email protected].
⁸ Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, China. [email protected].
⁹ Department of General Surgery, Pancreatic Disease Center, Shanghai Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, No.197 Ruijin Er Road, Shanghai, 200025, China. [email protected].
¹⁰ Research Institute of Pancreatic Diseases, Shanghai Jiao Tong University School of Medicine, No.197 Ruijin Er Road, Shanghai, 200025, China. [email protected].
¹¹ State Key Laboratory of Oncogenes and Related Genes, No.197 Ruijin Er Road, Shanghai, 200025, China. [email protected].
¹² Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, China. [email protected].

^# Contributed equally.

Abstract

Background: The association between body mass index (BMI) and the overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) patients remains controversial and unclear, METHOD: A total of 2010 patients from a high-volume center were enrolled in the study. The OS of PDAC patients was evaluated based on restricted cubic spline (RCS), propensity score (PS) and multivariable risk adjustment analyses.

Result: BMI was linearly related to the OS (total P = 0.004, nonlinear P = 0.124). BMI was analyzed as categorical data based on X-tile software-defined cutoffs and World Health Organization (WHO)-recommended cutoffs. Adjusted with confounding covariates, higher BMI manifested as a positive prognostic predictor. Furthermore, BMI was proven to be associated with the OS in the PS analysis. (Underweight_Xtile vs. Normal_XtileP = 0.003, Overweight_Xtile vs. Normal_XtileP = 0.019; Underweight_WHO vs. Normal_WHOP < 0.001, Overweight_WHO vs. Normal_WHOP = 0.024). It was also revealed that patients with higher BMI benefitted more from chemotherapy. (Adjusted hazard ratio (aHR): Underweight_Xtile vs. Normal_Xtile vs. Overweight_Xtile: 0.565 vs. 0.474 vs. 0.409; Underweight_WHO vs. Normal_WHO vs. Overweight_WHO: 0.613 vs. 0.464 vs. 0.425).

Conclusion: Among PDAC patients, there was a positive association between BMI and the OS, especially in patients treated with chemotherapy.

Keywords: Body mass index (BMI). Pancreatic ductal adenocarcinoma (PDAC). Overall survival (OS). Restricted cubic spline (RCS). Chemotherapy.

MeSH terms

Aged
Antineoplastic Agents / therapeutic use
Body Mass Index*
Carcinoma, Pancreatic Ductal* / epidemiology
Carcinoma, Pancreatic Ductal* / mortality
Female
Humans
Male
Middle Aged
Overweight / epidemiology
Pancreatic Neoplasms* / epidemiology
Pancreatic Neoplasms* / mortality
Retrospective Studies
Thinness / epidemiology

Substances

Antineoplastic Agents