Allergies, obesity, other risk factors and survival from pancreatic cancer.
Survival from pancreatic adenocarcinoma remains extremely poor, approximately 5% at 5 years. Risk factors include smoking, high body mass index (BMI), family history of pancreatic cancer, and long-standing diabetes; in contrast, allergies are associated with reduced risk. Little is known about associations between these factors and survival. We analyzed overall survival in relation to risk factors for 475 incident cases who took part in a hospital based case-control study. Analyses were conducted separately for those who did (160) and did not (315) undergo tumor resection. Kaplan-Meier methods were used to describe survival according to smoking, BMI, family history, diabetes, and presence of allergies. Cox proportional hazards models were used to adjust for covariates. There was no association with survival based on smoking, family history, or history of diabetes in either group. Among patients with resection, those with allergies showed nonstatistically significant longer survival, a median of 33.1 months (95% CI: 19.0-52.5) vs. 21.8 months (95% CI: 18.0-33.1), p = 0.25. The adjusted hazard ratio (HR) was 0.72 (95% CI: 0.43-1.23), p = 0.23. Among patients without resection, those with self-reported allergies survived significantly longer than those without allergies: 13.3 months (95% CI: 10.6-16.9) compared to 10.4 months (95% CI: 8.8-11.0), p = 0.04, with an adjusted HR of 0.68 (95% CI: 0.49-0.95), p = 0.02. Obesity was nonsignificantly associated with poorer survival, particularly in the resected group (HR = 1.62, 95% CI: 0.76-3.44). The mechanisms underlying the association between history of allergies and improved survival are unknown. These novel results need to be confirmed in other studies.
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. olsons@mskcc.org
Sara H
SH
Olson
Joanne F
JF
Chou
Emmy
E
Ludwig
Eileen
E
O'Reilly
Peter J
PJ
Allen
William R
WR
Jarnagin
Sharon
S
Bayuga
Jennifer
J
Simon
Mithat
M
Gonen
William R
WR
Reisacher
Robert C
RC
Kurtz
D000230:Adenocarcinoma / Q000453:epidemiology*; D000368:Aged; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005192:Family Health; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000453:epidemiology*; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D015996:Survival Rate; D014481:United States / Q000453:epidemiology