Cachexia but not obesity worsens the postoperative outcome after pancreatoduodenectomy in pancreatic cancer
Section snippets
Patients
Of 2,968 consecutive pancreatic resections performed at the Department of General Surgery of the University of Heidelberg between October 2001 and July 2010, 794 were pancreatoduodenectomies for primary pancreatic adenocarcinoma. Of those, 408 patients whose preoperative computed tomographic (CT) or magnetic resonance imaging (MRI) scans were available in the electronic radiologic database were identified. Patients with incomplete CT or MRI scans that did not allow the evaluation of body fat
Patient and tumor data
Fifty-eight percent of patients were male, and 42% were female. The mean age of the study cohort was 65.2 years (range, 40–88), the mean body weight was 72 kg (range, 42–140), and the mean BMI was 24.6 (range, 15.1–48.4; Table). The mean AWF thickness was 22.5 mm (range, 1–73), and cut-off points for statistical analysis were set at 20 and 25 mm. Three size-adjusted subgroups were therefore created. The mean HGF thickness was 48 mm (range, 5–114) with subgroup size–calibrating cut-off points at
Discussion
The increasing prevalence of obesity is a serious health problem in most Western countries. BMI >30 kg/m2 has been identified as a risk factor for cardiovascular disease and diabetes,25, 26, 27 and has been associated with an increased risk for developing various cancers.28, 29, 30 In addition, increased operative morbidity and mortality rates have been described for several oncologic resections in obese patients.15, 31 In contrast to previous studies, the present analysis from a large center
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Drs Pausch and Hartwig contributed equally to this manuscript.