title: Impact of obesity and body fat distribution on survival after pancreaticoduodenectomy for pancreatic adenocarcinoma.
abstract: BACKGROUND
  Epidemiologic studies have reported a positive correlation between body mass index (BMI) and pancreatic cancer risk, but clinical relevance of obesity and/or body fat distribution on tumor characteristics and cancer-related outcome remain controversial. We sought to assess the influence of obesity and body fat distribution on pathologic characteristics and survival after pancreaticoduodenectomy for pancreatic adenocarcinoma.
  
  
  METHODS
  Demographic and biometric data were collected on 328 patients undergoing pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. In a subset of patients, pancreatic fatty infiltration and fibrosis were assessed pathologically, and visceral fat area (VFA) was evaluated. Influence of BMI and body fat distribution on tumor characteristics and survival were evaluated.
  
  
  RESULTS
  A significant positive correlation between BMI and VFA was observed, with a wide range of VFA value within each BMI class. According to BMI or VFA distribution, there were no significant differences in patient characteristics, intraoperative or perioperative outcome, or pathologic characteristics, with the exception of significantly higher blood loss in patients with an increased body weight or VFA. Unadjusted overall and disease-free survival between BMI class and VFA quartile were not significantly different.
  
  
  CONCLUSIONS
  In this study, obesity and body fat distribution were not correlated with specific tumor characteristics or cancer-related outcome.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Gaujoux
authors.forename: Javiera
authors.initials: J
authors.lastname: Torres
authors.forename: Sara
authors.initials: S
authors.lastname: Olson
authors.forename: Corrine
authors.initials: C
authors.lastname: Winston
authors.forename: Mithat
authors.initials: M
authors.lastname: Gonen
authors.forename: Murray F
authors.initials: MF
authors.lastname: Brennan
authors.forename: David S
authors.initials: DS
authors.lastname: Klimstra
authors.forename: Michael
authors.initials: M
authors.lastname: D'Angelica
authors.forename: Ronald
authors.initials: R
authors.lastname: DeMatteo
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
authors.forename: Michael
authors.initials: M
authors.lastname: House
authors.forename: William
authors.initials: W
authors.lastname: Jarnagin
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kurtz
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Allen
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D000368:Aged; D016063:Blood Loss, Surgical; D050218:Body Fat Distribution; D015992:Body Mass Index; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric; D015996:Survival Rate