A study presented at the 2010 Digestive Disease Week Annual Meeting found that intra-abdominal fat was a predictor of survival in patients with pancreatic cancer, and the greater the amount of intra-abdominal fat, the worse the survival.¹ The meeting was held May 1-5 in New Orleans.

"Obesity is linked to increased risk of several types of cancer, including colon, breast, prostate, and endometrial. In our study, the location of the fat was the key to survival rates," said David H. Berger, MD, coauthor of the paper. Dr. Berger is Professor of Surgery at Baylor College of Medicine, Houston.

This study used intra-abdominal fat as a measure of obesity because body mass index (BMI) is not considered reliable. "Arnold Schwarzenegger has a large BMI but no fat," stated the paper's coauthor, Courtney Balentine, MD, a research fellow at Baylor.

No Extra Imaging Required

Intra-abdominal fat was measured by CT scan in 61 patients who underwent a Whipple procedure for exocrine pancreatic adenocarcinoma during the years 2000 to 2009. The authors noted that CT scans are routinely performed prior to this type of surgery, so measuring intra-abdominal fat required no extra imaging. For comparison purposes, BMI was measured as part of the physical exam.

After adjusting for age and perineural invasion status, the investigators found that preoperative BMI was not a significant predictor of overall survival, whereas the quartile of intra-abdominal fat did affect survival in a nonlinear fashion. People in the second quartile of intra-abdominal fat had a fourfold increased likelihood of death (HR = 4.018, 95% CI = 1.099-14.687, P < .035) compared with the lowest quartile. Those in the third and fourth quartile had a greater risk of death than those in the lower quartiles, but this difference did not reach statistical significance.

According to Dr. Balentine, this novel approach to measuring intra-abdominal fat should be used to further explore the relationship between obesity and outcomes in pancreatic cancer.  ■

Reference

1. Berger DH, et al: Intra-abdominal fat predicts survival in pancreatic cancer. 2010 Digestive Disease Week. Abstract W1681. Presented May 5, 2010.