Sa1381 The Association of Visceral Obesity and Poor Prognosis in Pancreatic Cancer

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Background/Aims: An association between obesity and unfavorable outcomes for various types of malignancy has been established. Nevertheless, the impact of visceral obesity on outcomes in pancreatic cancer is still unknown and controversial. The aim of this study was to uncover an association between visceral fat and pancreatic cancer outcomes. METHODS: We retrospectively reviewed 237 patients in pancreatic cancer who were diagnosed and treated in the Severance Hospital from January 2006 to December 2011, and collected the data of the clinical features, pathologic finding, staging, tumor marker and history of surgery, radiation therapy or chemotherapy. In this study, disease free survival (DFS), progression free survival (PFS) and overall survival (OS) were used as factors of cancer prognosis to evaluate association with visceral obesity (defined as an abdominal fat volume distribution using CT scan; the percentage of visceral fat (VF%) to total fat area) at initial diagnosis. RESULTS: Among 237 patients, male was 127 (53.6%) and the mean age at diagnosis was 63.7±9.3 years old. The cancer stage at diagnosis was as follows, 6 (2.5%) patients in stage I, 50 (21.1%) in stage II, 62 (26.2%) in stage III and 119 (50.2%) in stage IV. The mean VF% at diagnosis was 47.9±11.8 and the patients with VF% ≥ 50.0 who had a relatively high visceral obesity was 101 (42.6%). Compared with low visceral obesity group (low-VO group, N=136), the high visceral obesity group (high-VO group, N=101) was associated with old age (62.6±9.4 vs. 65.0±9.0 years old, p=0.047), male gender (30.1% (41/136) vs. 85.1% (86/101), p<0.001) and current smoking status (12.5% (17/136) vs. 26.7% (27/101), p<0.001). The recurrence rate and progression rate were significantly higher in the high-VO group than the low-VO group (recurrence rate: 60.0% (18/30) vs. 100.0% (8/8), p=0.031, progression rate: 89.6% (120/134) vs. 98.0% (99/101), p=0.011). The mortality rate was also higher in the high-VO group although there was no statistical significance (89.7% (122/136) vs. 96.0% (97/101), p=0.069). The DFS, PFS and OS were significantly shorter by the Kaplan-Meier method in the high-VO group than the low-VO group (DFS: 8.4±2.8 months vs. 48.5±9.2 months, p=0.005, PFS: 4.7±1.3 months vs. 13.1±2.7months, p=0.007, OS: 13.1±1.6 months vs. 22.2±2.6months, p=0.003). CONCLUSION: Visceral obesity at the time of diagnosis is associated with negative outcome, such as shorter DFS, PFS and OS, in patients with pancreatic cancer.