Abstract
BACKGROUND: Obesity may contribute to pancreatic cancer development via metabolic modulation. The number of obese patients with pancreatic cancer is expected to increase worldwide. Herein, we investigated the effects of obesity on patients with pancreatic head cancer who underwent pancreaticoduodenectomy (PD). METHODS: We reviewed 141 consecutive PDs and compared clinicopathological factors and survival outcomes in obese (O: 29 patients) or non-obese (N: 112 patients) groups. Obesity was defined as a body mass index > 25 kg/m(2). RESULTS: Intraoperative bleeding was higher in the O group than in the N group (450 vs. 280 mL, p < 0.001); however, there were no intergroup differences in operation time, frequencies of Clavien-Dindo grade Ⅲ or higher morbidities, pancreatic fistula grade B or higher, or postoperative hospital stay duration. There were no significant intergroup differences in the radical resection rate, but the O group had more advanced tumor-related factors than the N group, with higher lymphatic invasion (79 vs. 46%, p = 0.002) and lymph node metastasis rates (90 vs. 68%, p = 0.019). There was no intergroup difference in the rate of postoperative adjuvant therapy; however, the recurrence rate tended to be higher (83% vs. 69%, p = 0.136), whereas early recurrence within 6 months was significantly higher (38% vs. 19%, p = 0.02), in the O group than the N group. In addition, the median recurrence-free survival was significantly shorter in the O group than in the N group (7.6 vs. 17.3 months, p = 0.037). CONCLUSIONS: Obesity was associated with early recurrence in patients undergoing PD for pancreatic head cancer.