Boram Lee, Ho-Seong Han, Yoo-Seok Yoon, Yeshong Park, MeeYoung Kang, Jinju Kim
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"Obesity Paradox" as a new insight from long-term survivors in pancreatic cancer patients.
Background: Obesity is traditionally associated with poor outcomes. However, the recently emerging concept of the "obesity paradox" suggests that obese cancer patients have better survival rates than non-obese patients. While this phenomenon has been confirmed in several cancers, its relevance to pancreatic cancer remains unclear. This retrospective study explores whether the obesity paradox applies to pancreatic cancer (PC) after pancreatectomy.
Methods: A total of 404 PC patients who underwent surgery between 2004 and 2022 were studied. Patients were classified into the non-obese (BMI <25.0) (n = 313) and obese (BMI ≥25.0) (n = 91) groups. A subgroup analysis examined the impact of the visceral fat to subcutaneous fat ratio (VSR) on survival within the obese cohort.
Results: Obese patients had a significantly better 5-year overall survival (p = 0.040) and cancer-specific survival (p = 0.047) than non-obese patients. Within the obese cohort, a lower VSR was associated with improved survival (p = 0.012), indicating the importance of fat distribution in outcomes.
Conclusion: Obesity is associated with improved survival in patients with PC, highlighting the potential benefits of a nuanced approach to manageing obese patients. Distribution of adipose tissue, particularly subcutaneous fat relative to visceral fat, further influences survival, suggesting that tailored treatment strategies may improve outcomes.
期刊介绍：
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
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HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
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