Obesity and Pancreatic Cancer: A Matched-Pair Survival Analysis
Background: Morbid obesity is a risk factor for pancreatic ductal adenocarcinoma (PDAC). However, the impact of obesity on postoperative outcomes and overall survival in patients with PDAC remains a controversial topic. Methods: Patients who underwent pancreatic surgery for PDAC between 1997 and 201...
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doaj-164b1386b9bb4cb2ba2ba3d618f112eb2020-11-25T03:58:31ZengMDPI AGJournal of Clinical Medicine2077-03832020-10-0193526352610.3390/jcm9113526Obesity and Pancreatic Cancer: A Matched-Pair Survival AnalysisPatrick Téoule0Erik Rasbach1Hani Oweira2Mirko Otto3Nuh N. Rahbari4Christoph Reissfelder5Felix Rückert6Emrullah Birgin7Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyHirslanden Hospital Group, Cham, Rigistrasse 1, 6330 Cham, SwitzerlandDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyBackground: Morbid obesity is a risk factor for pancreatic ductal adenocarcinoma (PDAC). However, the impact of obesity on postoperative outcomes and overall survival in patients with PDAC remains a controversial topic. Methods: Patients who underwent pancreatic surgery for PDAC between 1997 and 2018 were included in this study. Matched pairs (1:1) were generated according to age, gender and American Society of Anesthesiologists status. Obesity was defined according to the WHO definition as BMI ≥ 30 kg/m<sup>2</sup>. The primary endpoint was the difference in overall survival between patients with and without obesity. Results: Out of 553 patients, a total of 76 fully matched pairs were generated. Obese patients had a mean BMI-level of 33 compared to 25 kg/m<sup>2</sup> in patients without obesity (<i>p</i> = 0.001). The frequency of arterial hypertension (<i>p</i> = 0.002), intraoperative blood loss (<i>p</i> = 0.039), and perineural invasion (<i>p</i> = 0.033) were also higher in obese patients. Clinically relevant postoperative complications (<i>p</i> = 0.163) and overall survival rates (<i>p</i> = 0.885) were comparable in both study groups. Grade II and III obesity resulted in an impaired overall survival, although this was not statistically significant. Subgroup survival analyses revealed no significant differences for completion of adjuvant chemotherapy and curative-intent surgery. Conclusions: Obesity did not affect overall survival and postoperative complications in these patients with PDAC. Therefore, pancreatic surgery should not be withheld from obese patients.https://www.mdpi.com/2077-0383/9/11/3526obesitypancreatic ductal adenocarcinomasurvivalmorbiditymortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Patrick Téoule Erik Rasbach Hani Oweira Mirko Otto Nuh N. Rahbari Christoph Reissfelder Felix Rückert Emrullah Birgin |
spellingShingle |
Patrick Téoule Erik Rasbach Hani Oweira Mirko Otto Nuh N. Rahbari Christoph Reissfelder Felix Rückert Emrullah Birgin Obesity and Pancreatic Cancer: A Matched-Pair Survival Analysis Journal of Clinical Medicine obesity pancreatic ductal adenocarcinoma survival morbidity mortality |
author_facet |
Patrick Téoule Erik Rasbach Hani Oweira Mirko Otto Nuh N. Rahbari Christoph Reissfelder Felix Rückert Emrullah Birgin |
author_sort |
Patrick Téoule |
title |
Obesity and Pancreatic Cancer: A Matched-Pair Survival Analysis |
title_short |
Obesity and Pancreatic Cancer: A Matched-Pair Survival Analysis |
title_full |
Obesity and Pancreatic Cancer: A Matched-Pair Survival Analysis |
title_fullStr |
Obesity and Pancreatic Cancer: A Matched-Pair Survival Analysis |
title_full_unstemmed |
Obesity and Pancreatic Cancer: A Matched-Pair Survival Analysis |
title_sort |
obesity and pancreatic cancer: a matched-pair survival analysis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-10-01 |
description |
Background: Morbid obesity is a risk factor for pancreatic ductal adenocarcinoma (PDAC). However, the impact of obesity on postoperative outcomes and overall survival in patients with PDAC remains a controversial topic. Methods: Patients who underwent pancreatic surgery for PDAC between 1997 and 2018 were included in this study. Matched pairs (1:1) were generated according to age, gender and American Society of Anesthesiologists status. Obesity was defined according to the WHO definition as BMI ≥ 30 kg/m<sup>2</sup>. The primary endpoint was the difference in overall survival between patients with and without obesity. Results: Out of 553 patients, a total of 76 fully matched pairs were generated. Obese patients had a mean BMI-level of 33 compared to 25 kg/m<sup>2</sup> in patients without obesity (<i>p</i> = 0.001). The frequency of arterial hypertension (<i>p</i> = 0.002), intraoperative blood loss (<i>p</i> = 0.039), and perineural invasion (<i>p</i> = 0.033) were also higher in obese patients. Clinically relevant postoperative complications (<i>p</i> = 0.163) and overall survival rates (<i>p</i> = 0.885) were comparable in both study groups. Grade II and III obesity resulted in an impaired overall survival, although this was not statistically significant. Subgroup survival analyses revealed no significant differences for completion of adjuvant chemotherapy and curative-intent surgery. Conclusions: Obesity did not affect overall survival and postoperative complications in these patients with PDAC. Therefore, pancreatic surgery should not be withheld from obese patients. |
topic |
obesity pancreatic ductal adenocarcinoma survival morbidity mortality |
url |
https://www.mdpi.com/2077-0383/9/11/3526 |
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