The association between body mass index (BMI) and the overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) patients remains controversial and unclear, Method: A total of 2010 patients from a high-volume center were enrolled in the study. The OS of PDAC patients was evaluated based on restricted cubic spline (RCS), propensity score (PS) and multivariable risk adjustment analyses. | Fu et al. BMC Cancer 2021 21 1318 https s12885-021-09056-0 RESEARCH Open Access Higher body mass index indicated better overall survival in pancreatic ductal adenocarcinoma patients a real-world study of 2010 patients Ningzhen Fu1 2 3 4 Yu Jiang1 2 3 4 Kai Qin1 2 3 4 Hao Chen1 2 3 4 Xiaxing Deng1 2 3 4 and Baiyong Shen1 2 3 4 Abstract Background The association between body mass index BMI and the overall survival OS of pancreatic ductal adenocarcinoma PDAC patients remains controversial and unclear Method A total of 2010 patients from a high-volume center were enrolled in the study. The OS of PDAC patients was evaluated based on restricted cubic spline RCS propensity score PS and multivariable risk adjustment analyses. Result BMI was linearly related to the OS total P nonlinear P . BMI was analyzed as categori- cal data based on X-tile software-defined cutoffs and World Health Organization WHO -recommended cutoffs. Adjusted with confounding covariates higher BMI manifested as a positive prognostic predictor. Furthermore BMI was proven to be associated with the OS in the PS analysis. UnderweightXtile vs. NormalXtileP OverweightXtile vs. NormalXtileP UnderweightWHO vs. NormalWHOP Fu et al. BMC Cancer 2021 21 1318 Page 2 of 11 controversial 6 10 . Limited by sample size and debat- Methods able statistics in what way BMI affects the OS was not Data collection convincingly determined in previous studies. In this All eligible patients pathologically diagnosed with PDAC study relying on propensity score PS analysis and were consecutively enrolled from the Pancreatic Dis- multivariable risk adjustment analysis we sought for ease Center at the Ruijin Hospital Affiliated to Shanghai the association between BMI and the OS. Based on our Jiao Tong University School of Medicine from results further studies could be designed to explore to . The exclusion criteria were as follows 1 no the underlying mechanisms and .
