Annals of Surgical Oncology

, Volume 24, Issue 12, pp 3732–3740 | Cite as

Visceral Adiposity and Sarcopenic Visceral Obesity are Associated with Poor Prognosis After Resection of Pancreatic Cancer

  • Shinya Okumura
  • Toshimi Kaido
  • Yuhei Hamaguchi
  • Atsushi Kobayashi
  • Hisaya Shirai
  • Siyuan Yao
  • Shintaro Yagi
  • Naoko Kamo
  • Etsuro Hatano
  • Hideaki Okajima
  • Kyoichi Takaori
  • Shinji Uemoto
Pancreatic Tumors

Abstract

Background

Visceral fat accumulation and muscle depletion have been identified as poor prognostic factors for various cancers. However, the significance of visceral adiposity and sarcopenic visceral obesity on outcomes after resection of pancreatic cancer remains unclear.

Methods

A retrospective analysis of 301 patients who underwent resection for localized pancreatic cancer between 2004 and 2015 was performed. The extent of visceral adiposity [visceral to subcutaneous adipose tissue area ratio (VSR)] and visceral obesity [visceral fat area (VFA)] were measured on preoperative computed tomography images, together with skeletal muscle index (SMI) and muscle attenuation (MA). The impacts of these body composition parameters on outcomes after pancreatic resection were investigated.

Results

The overall survival (OS) and recurrence-free survival (RFS) rates in patients with high VSR were significantly lower than those in patients with low VSR (P = 0.001, P = 0.007, respectively). There were no differences in OS and RFS between high VFA and low VFA group; however, when analyzed together with sarcopenic factors, OS and RFS rates of the patients with sarcopenic visceral obesity were significantly lower compared with those of the others. Multivariate analyses revealed that high VSR was an independent risk factor for mortality (hazard ratio (HR) 1.58, P = 0.009) and recurrence (HR 1.41, P = 0.026) together with low SMI, low MA, high CA19-9, microvascular invasion, and nodal metastasis.

Conclusions

Visceral adiposity and sarcopenic visceral obesity, as well as low muscle mass and quality, were closely associated with mortality and recurrence after resection of pancreatic cancer.

Notes

Acknowledgement

The authors thank Ms. Sayaka Tokuda, Ms. Yukiko Shimizu, Ms. Noriko Watanabe, Ms. Yu Aimi, and Ms. Mayumi Kawashima at Kyoto University Hospital for their kind help in collecting clinical data.

Disclosure

The authors declare that there are no conflicts of interest in relation to this study. No financial support was received from any source for this study.

Supplementary material

10434_2017_6077_MOESM1_ESM.docx (134 kb)
Supplementary material 1 (DOCX 133 kb)

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Shinya Okumura
    • 1
  • Toshimi Kaido
    • 1
  • Yuhei Hamaguchi
    • 1
  • Atsushi Kobayashi
    • 1
  • Hisaya Shirai
    • 1
  • Siyuan Yao
    • 1
  • Shintaro Yagi
    • 1
  • Naoko Kamo
    • 1
  • Etsuro Hatano
    • 1
  • Hideaki Okajima
    • 1
  • Kyoichi Takaori
    • 1
  • Shinji Uemoto
    • 1
  1. 1.Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan

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