Intra-abdominal Fat Predicts Survival in Pancreatic Cancer

• Published in: Journal of gastrointestinal surgery Vol. 14; no. 11; pp. 1832 - 1837
• Main Authors: Balentine, Courtney J., Enriquez, Jose, Fisher, William, Hodges, Sally, Bansal, Vivek, Sansgiry, Shubhada, Petersen, Nancy J., Berger, David H.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.11.2010; Springer Nature B.V
• Subjects: 2010 SSAT Poster Presentation; Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Aged; Body fat; Body Mass Index; Female; Gastroenterology; Health risk assessment; Humans; Intra-Abdominal Fat - diagnostic imaging; Intra-Abdominal Fat - pathology; Male; Medicine; Medicine & Public Health; Obesity; Obesity - complications; Obesity - diagnosis; Pancreatic cancer; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy; Prognosis; Risk Factors; Surgery; Survival Rate; Tomography, X-Ray Computed; Weight control; Obesity; Survival; Pancreaticoduodenectomy
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-010-1297-5

Background Body mass index (BMI) has proven unreliable in predicting survival following pancreaticoduodenectomy for cancer. While measures of intra-abdominal fat correlate with medical and postoperative complications of obesity, the impact of intra-abdominal fat on pancreatic cancer survival is uncertain. We hypothesized that the quantity of intra-abdominal fat would predict survival following resection of pancreatic cancer. Methods Preoperative CT imaging was used to measure intra-abdominal fat. Cox regression analyses were used to identify independent predictors of survival. Results Sixty-one patients from 2000–2009 underwent pancreaticoduodenectomy for exocrine pancreatic adenocarcinoma. After adjusting for age and perineural invasion status, preoperative BMI did not predict overall survival ( p  < 0.827). Unlike BMI, quartile of intra-abdominal fat predicted survival. Relative to patients with the least intra-abdominal fat (lowest quartile), those with more intra-abdominal fat demonstrated worse overall survival, but in a non-linear fashion. Individuals in the second quartile showed a fourfold increase in likelihood of death (HR 4.018, 95% CI 1.099–14.687, p  < 0.035) relative to the lowest quartile. Patients in the third (HR 2.124, 95% CI 0.278–16.222, p  < 0.468) and fourth quartile (HR 1.354, 95% CI 0.296–6.190, p  < 0.696) also showed greater risk of death. Conclusions Measuring intra-abdominal fat identifies a subset of patients with worse prognosis in pancreatic cancer.