title: The impact of body mass index dynamics on survival of patients with advanced pancreatic cancer receiving chemotherapy.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Younak
authors: Y
authors: Choi
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Tae-Yong
authors: TY
authors: Kim
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Kyung-hun
authors: KH
authors: Lee
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Sae-Won
authors: SW
authors: Han
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: ohdoyoun@snu.ac.kr.
authors: Do-Youn
authors: DY
authors: Oh
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Seock-Ah
authors: SA
authors: Im
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Tae-You
authors: TY
authors: Kim
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Yung-Jue
authors: YJ
authors: Bang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D015431:Weight Loss; D055815:Young Adult
keywords: Body mass index; advanced pancreatic cancer; chemotherapy; obesity; prognosis; survival