title: Influence of obesity on cancer-related outcomes after pancreatectomy to treat pancreatic adenocarcinoma.
abstract: OBJECTIVE
  To examine the influence of obesity, as measured by body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared), on clinicopathologic factors and survival after pancreatectomy to treat adenocarcinoma.
  
  
  METHODS
  Retrospective review and statistical analysis using prospectively collected data.
  
  
  METHODS
  Referral center with a dedicated multidisciplinary pancreas cancer program.
  
  
  METHODS
  Two hundred eighty-five consecutive patients with data available for BMI calculation who underwent potentially curative pancreas resection to treat adenocarcinoma from January 1, 1999, to October 31, 2006.
  
  
  METHODS
  Influence of BMI and other known prognostic variables on the incidence of lymph node metastasis and disease-free and overall survival.
  
  
  RESULTS
  We identified a subset of obese patients (BMI >35) who were at 12-fold risk of lymph node metastasis compared with nonobese patients (BMI < or =35). The estimated disease-free and overall survival rates were decreased in the obese patients, and the risk of cancer recurrence and death after pancreatectomy was nearly twice that in nonobese patients.
  
  
  CONCLUSIONS
  Obese patients with a BMI of more than 35 are more likely to have node-positive pancreatic cancer and decreased survival after surgical resection. Data suggest that the negative influence of BMI of more than 35 on cancer-related end points is unrelated to the potential complexity of performing major oncologic surgery in obese patients.
authors.affiliation: Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1400 Holcombe Blvd, Unit 444, Houston, TX 77030, USA. jbflemin@mdanderson.org
authors.forename: Jason B
authors.initials: JB
authors.lastname: Fleming
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Gonzalez
authors.forename: Maria Q B
authors.initials: MQ
authors.lastname: Petzel
authors.forename: E
authors.initials: E
authors.lastname: Lin
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Morris
authors.forename: Henry
authors.initials: H
authors.lastname: Gomez
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lee
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Crane
authors.forename: Peter W T
authors.initials: PW
authors.lastname: Pisters
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000601:surgery*; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications* / Q000401:mortality; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome