Trayectorias a corto plazo del IMC como predictor pronóstico en pacientes con cáncer de páncreas

While numerous studies have examined the association between body mass index (BMI) and cancer prognosis, most have only captured BMI at a single time point. Whether BMI trajectories are linked to the prognosis of pancreatic cancer remains unclear. This study aimed to investigate the relationship between short-term BMI trajectories and clinical outcomes in patients with pancreatic cancer.

A retrospective study was performed on 200 pancreatic cancer patients who admitted to our hospital from January 1, 2017 to December 31, 2021. BMI 1 (BMI of patients diagnosed with pancreatic cancer 1 year before), BMI 2 (BMI of the patient at diagnosis of pancreatic cancer), BMI 3 (BMI of patients 6 months after diagnosis of pancreatic cancer), BMI 4 (BMI 1-BMI 2), BMI 5 (BMI 3-BMI 2) and BMI 6 (the longitudinal BMI trajectory) were recorded. Clinical-pathological characteristics, oncologic outcomes, progression free survival (PFS) and overall survival (OS) were collected. The prognostic significance was determined by Kaplan-Meier analysis, Cox proportional hazards and restricted cubic spline regression models.

We found that changes in BMI may be a predictor of pancreatic cancer survival. The results of the multivariate analysis of factors influencing the pancreatic cancer OS showed that BMI 4 ≥1.3 (HR: 1.69, 95% CI: 1.19-2.41, P = 0.004), BMI 5 <-0.3 (HR: 3.05, 95% CI: 2.01-4.65, P < 0.001) and BMI 6 (patients from normal BMI to low BMI, HR: 2.51, 95% CI: 1.09-5.77, P = 0.031; patients from high BMI to normal BMI, HR: 2.01, 95% CI: 1.09-3.70, P = 0.025) indicated higher mortality rate.

This study confirms that short-term BMI trajectories before and after diagnosis, as well as early during treatment, are independent prognostic factors for both overall survival and progression-free survival in pancreatic cancer patients. Particular attention should be paid to patients who are normal-weight at diagnosis but transition to a low-BMI category shortly after treatment, as they face the highest mortality risk.