Journal of Gastrointestinal Surgery

, Volume 14, Issue 11, pp 1832–1837 | Cite as

Intra-abdominal Fat Predicts Survival in Pancreatic Cancer

  • Courtney J. Balentine
  • Jose Enriquez
  • William Fisher
  • Sally Hodges
  • Vivek Bansal
  • Shubhada Sansgiry
  • Nancy J. Petersen
  • David H. Berger
2010 SSAT Poster Presentation

Abstract

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.

Keywords

Obesity Pancreaticoduodenectomy Survival 

Notes

The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2010

Authors and Affiliations

  • Courtney J. Balentine
    • 1
    • 2
    • 3
  • Jose Enriquez
    • 1
    • 2
    • 3
  • William Fisher
    • 1
    • 3
  • Sally Hodges
    • 1
    • 3
  • Vivek Bansal
    • 4
  • Shubhada Sansgiry
    • 5
  • Nancy J. Petersen
    • 5
  • David H. Berger
    • 1
    • 2
    • 5
  1. 1.Michael E DeBakey Department of SurgeryBaylor College of MedicineHoustonUSA
  2. 2.Michael E. DeBakey Veterans Affairs HospitalHoustonUSA
  3. 3.Elkins Pancreas CenterBaylor College of MedicineHoustonUSA
  4. 4.Department of RadiologyBaylor College of MedicineHoustonUSA
  5. 5.VA Health Services Research and Development Center for ExcellenceHoustonUSA

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