An increasing level of obesity was found to be associated with higher mortality among Western patients with pancreatic cancer in a systematic review and meta-analysis.
“We observed that premorbid obesity adversely influences pancreatic cancer-related mortality in a dose-dependent manner, independent of presence or absence of diabetes or type of treatment,” Siddharth Singh, MBBS, from University of California, La Jolla, and colleagues wrote. “This increased risk is observed primarily in the Western population but not in Asia-Pacific regions.”
Researchers reviewed literature in PubMed, Embase, Web of Science, Cochrane Library and Google Scholar from their inceptions through January 2015 and identified 13 studies with data on the association of overweight and obesity and mortality related to pancreatic cancer.
They compared mortality data between patients with pancreatic cancer who were obese, overweight or had normal BMI (the controls). Five studies with patients who had established pancreatic cancer and eight studies with patients who did not have cancer at inception but were followed for the development of pancreatic cancer and subsequent related mortality were included.
The researchers observed an increase in mortality related to pancreatic cancer in patients who were overweight (adjusted HR = 1.06; 95% CI, 1.02-1.11) or obese (adjusted HR = 1.31; 95% CI, 1.2-1.42) compared with controls. When the researchers analyzed only the patients who had established pancreatic cancer, the association persisted.
Mortality increased by 10% with each 1 kg/m2 increase in BMI (adjusted HR = 1.1; 95% CI, 1.05-1.15). Subgroup analysis showed that increased mortality was linked to obesity in Western populations (adjusted HR = 1.32; 95% CI, 1.22-1.42), but not in Asia-Pacific populations.
“Premorbid obesity and its underlying metabolic alterations and associated chronic inflammation may be a potential therapeutic target in improving mortality in this highly lethal cancer,” the researchers wrote. “In current treatment schemes, premorbid obesity should be considered as a marker of poor prognosis, with a focus on more aggressive intervention, and may be used as a stratification variable in interventional studies.” – by Suzanne Reist
Disclosure: The researchers report no relevant financial disclosures.