Sean J. Judge MD, Emily Manin MD, Joanne Chou MPH, Robert J. Torphy MD, Caitlin A. McIntyre MD, Vinod P. Balachandran MD, Michael I. D’Angelica MD, Jeffrey A. Drebin MD, Mithat Gönen PhD, William R. Jarnagin MD, T. Peter Kingham MD, Eileen M. O’Reilly MD, Wungki Park MD, Alice C. Wei MD, Alice Zervoudakis MD, Kevin C. Soares MD
{"title":"生物学性别和肥胖对胰腺癌术前患者肝脏复发和生存的影响","authors":"Sean J. Judge MD, Emily Manin MD, Joanne Chou MPH, Robert J. Torphy MD, Caitlin A. McIntyre MD, Vinod P. Balachandran MD, Michael I. D’Angelica MD, Jeffrey A. Drebin MD, Mithat Gönen PhD, William R. Jarnagin MD, T. Peter Kingham MD, Eileen M. O’Reilly MD, Wungki Park MD, Alice C. Wei MD, Alice Zervoudakis MD, Kevin C. Soares MD","doi":"10.1002/cncr.70088","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The influence of obesity and sex on outcomes in pancreatic adenocarcinoma (PDAC) remains unclear. The association between obesity (body mass index [BMI], ≥30) and biologic sex (male or female) for outcomes in patients with PDAC undergoing a surgery-first approach was investigated.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A prospectively maintained pancreatic cancer database at the Memorial Sloan Kettering Cancer Center was queried to identify all patients undergoing surgery with a pathologic diagnosis of PDAC. Clinicodemographic variables, outcomes, and tumor mutational analyses for all available patients were collected. Cumulative incidence of first recurrence involving the liver was estimated via a cumulative incidence function. Multivariable Cox regression was used to investigate the association between BMI and sex for overall survival.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>From 2012 to 2022, 939 patients were identified who underwent surgery with a final pathologic diagnosis of PDAC. Median age was 70 years, 52% were male, and 24% were obese (BMI, ≥30). When dichotomized by sex and obesity status (BMI, <30 or ≥30), females with obesity had the lowest cumulative incidence of liver recurrence at 12 and 24 months postsurgery compared to all other groups (13% [95% CI, 7.2%–20%] and 15% [8.7%–23%], respectively). Females with obesity had the longest median overall survival at 37 months.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>After curative surgery for pancreatic cancer, females with obesity have a significantly lower rate of liver recurrence and the longest median overall survival. This does not appear to be related to surgical quality, receipt of adjuvant therapy, or tumor mutational profile. Investigation into host immune, metabolic, and hormonal parameters is paramount to understanding these differences.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70088","citationCount":"0","resultStr":"{\"title\":\"Influence of biologic sex and obesity on liver recurrence and survival in patients undergoing upfront surgery for pancreatic adenocarcinoma\",\"authors\":\"Sean J. Judge MD, Emily Manin MD, Joanne Chou MPH, Robert J. Torphy MD, Caitlin A. McIntyre MD, Vinod P. Balachandran MD, Michael I. D’Angelica MD, Jeffrey A. Drebin MD, Mithat Gönen PhD, William R. Jarnagin MD, T. Peter Kingham MD, Eileen M. O’Reilly MD, Wungki Park MD, Alice C. Wei MD, Alice Zervoudakis MD, Kevin C. Soares MD\",\"doi\":\"10.1002/cncr.70088\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The influence of obesity and sex on outcomes in pancreatic adenocarcinoma (PDAC) remains unclear. The association between obesity (body mass index [BMI], ≥30) and biologic sex (male or female) for outcomes in patients with PDAC undergoing a surgery-first approach was investigated.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A prospectively maintained pancreatic cancer database at the Memorial Sloan Kettering Cancer Center was queried to identify all patients undergoing surgery with a pathologic diagnosis of PDAC. Clinicodemographic variables, outcomes, and tumor mutational analyses for all available patients were collected. Cumulative incidence of first recurrence involving the liver was estimated via a cumulative incidence function. Multivariable Cox regression was used to investigate the association between BMI and sex for overall survival.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>From 2012 to 2022, 939 patients were identified who underwent surgery with a final pathologic diagnosis of PDAC. Median age was 70 years, 52% were male, and 24% were obese (BMI, ≥30). When dichotomized by sex and obesity status (BMI, <30 or ≥30), females with obesity had the lowest cumulative incidence of liver recurrence at 12 and 24 months postsurgery compared to all other groups (13% [95% CI, 7.2%–20%] and 15% [8.7%–23%], respectively). Females with obesity had the longest median overall survival at 37 months.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>After curative surgery for pancreatic cancer, females with obesity have a significantly lower rate of liver recurrence and the longest median overall survival. This does not appear to be related to surgical quality, receipt of adjuvant therapy, or tumor mutational profile. Investigation into host immune, metabolic, and hormonal parameters is paramount to understanding these differences.</p>\\n </section>\\n </div>\",\"PeriodicalId\":138,\"journal\":{\"name\":\"Cancer\",\"volume\":\"131 18\",\"pages\":\"\"},\"PeriodicalIF\":5.1000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70088\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.70088\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer","FirstCategoryId":"3","ListUrlMain":"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.70088","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Influence of biologic sex and obesity on liver recurrence and survival in patients undergoing upfront surgery for pancreatic adenocarcinoma
Background
The influence of obesity and sex on outcomes in pancreatic adenocarcinoma (PDAC) remains unclear. The association between obesity (body mass index [BMI], ≥30) and biologic sex (male or female) for outcomes in patients with PDAC undergoing a surgery-first approach was investigated.
Methods
A prospectively maintained pancreatic cancer database at the Memorial Sloan Kettering Cancer Center was queried to identify all patients undergoing surgery with a pathologic diagnosis of PDAC. Clinicodemographic variables, outcomes, and tumor mutational analyses for all available patients were collected. Cumulative incidence of first recurrence involving the liver was estimated via a cumulative incidence function. Multivariable Cox regression was used to investigate the association between BMI and sex for overall survival.
Results
From 2012 to 2022, 939 patients were identified who underwent surgery with a final pathologic diagnosis of PDAC. Median age was 70 years, 52% were male, and 24% were obese (BMI, ≥30). When dichotomized by sex and obesity status (BMI, <30 or ≥30), females with obesity had the lowest cumulative incidence of liver recurrence at 12 and 24 months postsurgery compared to all other groups (13% [95% CI, 7.2%–20%] and 15% [8.7%–23%], respectively). Females with obesity had the longest median overall survival at 37 months.
Conclusions
After curative surgery for pancreatic cancer, females with obesity have a significantly lower rate of liver recurrence and the longest median overall survival. This does not appear to be related to surgical quality, receipt of adjuvant therapy, or tumor mutational profile. Investigation into host immune, metabolic, and hormonal parameters is paramount to understanding these differences.
期刊介绍:
The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society.
CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research