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The Impact of Body Mass Index Dynamics on Survival of Patients With Advanced Pancreatic Cancer Receiving Chemotherapy

Cited 13 time in Web of Science Cited 12 time in Scopus
Authors
Choi, Younak; Kim, Tae-Yong; Lee, Kyung-hun; Han, Sae-Won; Oh, Do-Youn; Im, Seock-Ah; Kim, Tae-You; Bang, Yung-Jue
Issue Date
2014-07
Citation
Journal of Pain and Symptom Management, Vol.48 No.1, pp.13-25
Keywords
Body mass indexobesityadvanced pancreatic cancerprognosissurvivalchemotherapy
Abstract
Context. High body mass index (BMI) is linked to an increased risk of developing pancreatic cancer (PC). However, in patients with advanced PC (APC), especially those receiving palliative chemotherapy, the impact of BMI on survival has not been investigated fully. Objectives. To assess changes in BMI during the course of APC and their impact on patient survival, specifically for those receiving palliative chemotherapy. Methods. Consecutive patients with APC, all of whom were treated with palliative chemotherapy, were enrolled during 2003-2010. Clinical characteristics and prognoses were analyzed. Results. A total of 425 patients participated (median age, 60.1 years). At diagnosis of APC, patients' BMI distribution of patients was as follow: <18.5 (45, 10.6%); 18.5-19.9 (67, 15.8%); 20.0-22.4 (156, 36.7%); 22.5-24.9 (107, 25.2%); 25.0-29.9 (49, 11.5%); and >= 30.0 (1, 0.2%). Median overall survival (OS) was 8.1 months (95% confidence interval 7.2, 9.1). Precancer BMI and baseline BMI (at diagnosis) had no impact on OS. Weight loss at diagnosis (precancer weight minus weight at diagnosis) and weight loss during first-line chemotherapy (both stipulated as BMI change >= 1) were associated with shortened OS (hazard ratio, 1.300; P = 0.012 and hazard ratio, 1.367; P = 0.010, respectively). Conclusion. In patients with APC undergoing palliative chemotherapy, decreases in BMI at APC diagnosis and during chemotherapy are more hazardous for OS than precancer BMI or baseline BMI (at diagnosis) as absolute values. Further studies are needed to validate this finding and investigate strategies to maintain BMI during chemotherapy in this setting. (C) 2014 U. S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
ISSN
0885-3924
URI
https://hdl.handle.net/10371/173168
DOI
https://doi.org/10.1016/j.jpainsymman.2013.08.017
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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