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

IF 5.1 2区 医学 Q1 ONCOLOGY
Cancer Pub Date : 2025-09-10 DOI:10.1002/cncr.70088
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
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引用次数: 0

摘要

背景:肥胖和性别对胰腺腺癌(PDAC)预后的影响尚不清楚。研究了肥胖(体重指数[BMI],≥30)和生理性别(男性或女性)对PDAC患者手术先入路预后的影响。方法查询纪念斯隆凯特琳癌症中心前瞻性维护的胰腺癌数据库,以确定所有病理诊断为PDAC的手术患者。收集所有可用患者的临床人口学变量、结果和肿瘤突变分析。累及肝脏的首次复发累积发生率通过累积发生率函数估计。采用多变量Cox回归分析BMI和性别对总生存率的影响。结果2012年至2022年,939例患者接受手术,最终病理诊断为PDAC。中位年龄70岁,52%为男性,24%为肥胖(BMI≥30)。当按性别和肥胖状况(BMI, <;30或≥30)进行二分类时,与所有其他组相比,肥胖女性在术后12个月和24个月的肝脏复发累积发生率最低(分别为13% [95% CI, 7.2%-20%]和15%[8.7%-23%])。肥胖女性的中位总生存期最长,为37个月。结论女性肥胖患者胰腺癌根治性手术后肝脏复发率明显降低,中位总生存期最长。这似乎与手术质量、接受辅助治疗或肿瘤突变特征无关。研究宿主免疫、代谢和激素参数对于理解这些差异至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Influence of biologic sex and obesity on liver recurrence and survival in patients undergoing upfront surgery for pancreatic adenocarcinoma

Influence of biologic sex and obesity on liver recurrence and survival in patients undergoing upfront surgery for pancreatic adenocarcinoma

Influence of biologic sex and obesity on liver recurrence and survival in patients undergoing upfront surgery for pancreatic adenocarcinoma

Influence of biologic sex and obesity on liver recurrence and survival in patients undergoing upfront surgery for pancreatic adenocarcinoma

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.

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来源期刊
Cancer
Cancer 医学-肿瘤学
CiteScore
13.10
自引率
3.20%
发文量
480
审稿时长
2-3 weeks
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
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