Abstract
Background: Whether body mass index (BMI) was associated with the overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) remained controversial and uncertain.Method: A total of 2,010 patients from single high-volume center were enrolled in the study. OS of PDAC patients was evaluated based on restricted cubic spline (RCS), propensity score (PS) and multivariable risk adjustment analyses. Result: BMI was discovered linear related with OS (total P=0.004, non-linear P=0.124). BMI was analyzed as categorical data based on X-tile software defined cutoffs and World Health Organization (WHO) recommended cutoffs, respectively. Adjusted with confounding covariates, higher BMI manifested as a positive prognostic predictor. (PXtile=0.003, PWHO=0.002) Furtherly, BMI was proven associated with OS in PS analysis. (UnderweightXtile vs. NormalXtile P=0.003, OverweightXtile vs. NormalXtile P=0.019; UnderweightWHO vs. NormalWHO P<0.001, OverweightWHO vs. NormalWHO P=0.024). It was also revealed that patients with higher BMI benefitted more from chemotherapy.(adjusted hazard ratio (aHR): UnderweightXtile: 0.565 (0.389-0.819), NormalXtile: 0.474 (0.395-0.567), OverweightXtile: 0.409 (0.337-0.496); UnderweightWHO: 0.613 (0.401-0.940), NormalWHO: 0.464 (0.387-0.557), OverweightWHO: 0.425 (0.353-0.512)). Conclusion: Among PDAC patients, higher BMI manifested as a favorable OS indicator, and the protective impact was probably based on chemotherapy administration. Patients with higher BMI were also observed with more chemotherapy administration and more OS benefits from chemotherapy.
Second-Look Operation for Unresectable Pancreatic Ductal Adenocarcinoma at a High-Volume Center