Intra-abdominal Fat Predicts Survival in Pancreatic Cancer
Intra-abdominal Fat Predicts Survival in Pancreatic Cancer
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DOI：
10.1007/s11605-010-1297-5
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发表时间：
2010-11-01
影响因子：
3.2
通讯作者：
Berger, David H.
中科院分区：
文献类型：
--
作者：
Balentine, Courtney J.;Enriquez, Jose;Berger, David H.
事实证明，体重指数（BMI）在预测癌症胰十二指肠切除术后的生存率方面并不可靠。虽然腹内脂肪的测量与肥胖的医疗和术后并发症相关，但腹内脂肪对胰腺癌生存的影响尚不确定。我们假设腹内脂肪的数量可以预测胰腺癌切除后的生存率。术前使用 CT 成像来测量腹内脂肪。 Cox 回归分析用于确定生存的独立预测因素。2000 年至 2009 年，61 名患者因外分泌胰腺腺癌接受了胰十二指肠切除术。调整年龄和神经周围侵犯状态后，术前 BMI 并不能预测总生存率 (p < 0.827)。与 BMI 不同，腹内脂肪的四分位数可以预测生存率。相对于腹内脂肪最少（最低四分位数）的患者，腹内脂肪较多的患者表现出较差的总体生存率，但呈非线性方式。相对于最低四分位的个体，第二四分位的个体死亡可能性增加了四倍（HR 4.018，95% CI 1.099-14.687，p < 0.035）。第三四分位数（HR 2.124，95% CI 0.278-16.222，p < 0.468）和第四四分位数（HR 1.354，95% CI 0.296-6.190，p < 0.696）的患者也表现出更高的死亡风险。测量腹内脂肪可识别胰腺癌预后较差的一部分患者。
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.Preoperative CT imaging was used to measure intra-abdominal fat. Cox regression analyses were used to identify independent predictors of survival.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.Measuring intra-abdominal fat identifies a subset of patients with worse prognosis in pancreatic cancer.