Influence of Obesity on Cancer-Related Outcomes After Pancreatectomy to Treat Pancreatic Adenocarcinoma

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. Design: Retrospective review and statistical analysis using prospectively collected data. Setting: Referral center with a dedicated multidisciplinary pancreas cancer program. Patients: 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. Main Outcome Measure: 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 <= 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.