High BMI led to poor survival, more recurrence after pancreatic resection

Obese patients were more likely to have recurrence following pancreatic resection compared with non-obese patients and were at 2.28-fold greater risk for the disease spreading to their lymph nodes, according to the results of a recent study.

Researchers at multiple sites in the United States performed a retrospective review of 285 patients treated with pancreatectomy for adenocarcinoma from 1999 to 2006. Twenty patients had BMI of 35 or more.

Patients with BMI >35 had the greatest percentage of stage IIb disease (95%) and the lowest percentage of IIa disease. No patient in the obese group had stage Ia or Ib disease.

Patients with a BMI >35 had a median survival of 13.2 months compared with 27.4 months for patients with a BMI <23. At the last follow-up, 75% of obese patients had died compared with 52% of non-obese patients.

The median time to recurrence for obese patients was 8.5 months (95% CI, 5.2-11.3). Researchers reported finding that obese patients were more likely to have recurrence than patients who had BMI <23 (P=.006). Ninety-five percent of patients in the obese group recurred compared with only 61% of all other patients.

The researchers acknowledged that obese patients are less likely to undergo preoperative therapy, but found that even after controlling for that variable obese patients were still at a 12-fold increased risk for lymph node metastases compared with non-obese patients.

Fleming JB. Arch Surg. 2009;144:216-221.