Obesity and survival in population-based patients with pancreatic cancer in the San Francisco Bay Area.
Obesity and survival in population-based patients with pancreatic cancer in the San Francisco Bay Area.
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DOI：
10.1007/s10552-012-0070-3
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发表时间：
2012-12
影响因子：
2.3
通讯作者：
Bracci, Paige M.
中科院分区：
文献类型：
--
作者：
Gong, Zhihong;Holly, Elizabeth A.;Bracci, Paige M.
肥胖一直与胰腺癌发病率和死亡率风险增加相关。然而，关于胰腺癌患者的肥胖和总体生存率的研究明显缺乏，特别是在基于人群的研究中。在旧金山湾区进行的一项大型人群病例对照研究中，采用主动和被动随访来确定 1995 年至 1999 年间诊断的 510 名胰腺癌患者的生命状态和生存情况。使用Kaplan-Meier 方法计算存活率。在多变量 Cox 比例风险模型中估计风险比 (HR) 和 95% 置信区间 (CI)，作为诊断前肥胖与胰腺癌生存之间关联的衡量标准。与 BMI 正常范围 (<25) 患者相比，肥胖（体重指数 [BMI] ≥ 30）患者的风险比升高 1.3（95% CI，0.91–1.81）。总体生存率与已知胰腺癌预后和危险因素之间的关联并没有因 BMI 的不同而显着变化（所有 P 交互作用≥0.18），但与正常 BMI 患者相比，肥胖患者的 HR 始终升高[诊断时的局限性疾病 (HR, 3.1)、手术切除 (HR, 1.6)、曾经吸烟者 (HR, 1.6)、糖尿病患者 (HR, 3.3)]。在男性、老年患者、近期和当前吸烟者中观察到生存率较低，而在亚洲/太平洋岛民中观察到生存率有所提高。总的来说，我们的结果对诊断前肥胖与胰腺癌患者生存率降低之间的关联提供了有限的支持。某些患者亚组中与肥胖相关的生存率降低可能是偶然的，需要在更大规模的汇总研究中进行评估。
Obesity has been consistently associated with increased risk of pancreatic cancer incidence and mortality. However, studies of obesity and overall survival in patients with pancreatic cancer are notably lacking, especially in population-based studies. Active and passive follow-up were used to determine vital status and survival for 510 pancreatic cancer patients diagnosed from 1995–1999 in a large population-based case-control study in the San Francisco Bay Area. Survival rates were computed using Kaplan-Meier methods. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated in multivariable Cox proportional hazards models as measures of the association between pre-diagnostic obesity and pancreatic cancer survival. An elevated hazard ratio of 1.3 (95% CI, 0.91–1.81) was observed for obese (body mass index [BMI] ≥30) compared with normal range BMI (<25) patients. Associations between overall survival and known pancreatic cancer prognostic and risk factors did not significantly vary by BMI (all P-interaction ≥0.18), yet elevated HRs consistently were observed for obese compared with normal BMI patients [localized disease at diagnosis (HR, 3.1), surgical resection (HR, 1.6), ever smokers (HR, 1.6), diabetics (HR, 3.3)]. Poor survival was observed among men, older patients, more recent and current smokers, whereas improved survival was observed for Asian/Pacific Islanders. Our results in general provide limited support for an association between prediagnostic obesity and decreased survival in patients with pancreatic cancer. Patterns of reduced survival associated with obesity in some patient subgroups could be due to chance and require assessment in larger pooled studies.
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影响因子：
15.9
作者：
Kahn, BB;Flier, JS
通讯作者：
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影响因子：
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作者：
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作者：
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