BMI Linked to Poor Pancreatic Cancer Survival

November 5, 2013

Patients with a high body mass index prior to being diagnosed with pancreatic cancer had reduced survival from the disease and were more likely to present with late-stage cancer, according to the results of a recently published study.

Patients with a high body mass index (BMI) prior to being diagnosed with pancreatic cancer had reduced survival from the disease and were more likely to present with late-stage cancer, according to the results of a recently published study.

“These data emphasize the link between chronic alterations in systemic metabolism and pancreatic cancer survival and suggest obesity-related metabolic pathways for possible therapeutic intervention in patients with pancreatic adenocarcinoma,” wrote researchers led by Brian M. Wolpin, MD, of Brigham and Women’s Hospital.

Although multiple studies have shown a link between high BMI and an increased risk of developing pancreatic cancer, none had looked at the possible effect of prediagnostic BMI on pancreatic cancer survival.

Wolpin and colleagues looked at data from 902 patients from two large prospective cohorts of patients diagnosed with pancreatic cancer between 1988 and 2010. All patients had prediagnostic BMI data available. The researchers estimated hazard ratios for death according to BMI, adjusting for age, sex, race/ethnicity, smoking status, diagnosis year, and stage of disease. They published their results in Journal of Clinical Oncology.

The mean time from baseline BMI measurement to pancreatic cancer diagnosis was 14.7 years. Thirty-six percent of patients were considered overweight and 15% obese. Results indicated that those patients with a BMI of 35 or greater had a 53% increased risk of death compared with those with a BMI less than 25 (HR = 1.53; 95% CI, 1.11-2.09).

Furthermore, the researchers found a stronger association between BMI and survival when there was a longer lag time between reported BMI and cancer diagnosis. Overweight patients who had their BMI collected 18 to 20 years before diagnosis had more than twice the risk for death compared with healthy-weight patients (HR = 2.31; 95% CI, 1.48-3.61). The researchers said that these results suggest “the importance of chronic exposure to elevated BMI in the association with survival.”

Finally, those patients who had prediagnostic BMI of 35 or greater were more likely to be diagnosed with more advanced disease stage. Metastatic disease was found in 72.5% of obese patients compared with 59.4% of patients considered to be healthy weight (P = .02). However, even after the researchers adjusted data for stage, prediagnostic BMI was still an independent predictor of worse survival.