P4285 - No Impact of Body Mass Index (BMI) on Complications and Survival of Patients With Inoperable Pancreatic Ductal Adenocarcinoma (PDAC)

Ren Chase. Bryant, DO¹, Ruben Plentz, MD¹, Hannah Darnell, DO¹, Megan E. Hall, MS², Kristen McQuerry, PhD², Kelsey Karnik, PhD²
1University of Kentucky College of Medicine, Lexington, KY; 2University of Kentucky, Lexington, KY

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer death in U.S. with rising cases each year. There are multiple known PDAC risk factors including obesity. High body mass index (BMI) affects 40% among U.S. adults. There is controversial data about the impact of BMI in PDAC patients. The aim of the present study is to evaluate the influence of BMI on outcome and complications in patients with inoperable PDAC.

Methods: We retrospectively reviewed electronic health records of patients diagnosed with inoperable PDAC (n=162) at the University of Kentucky from January 1, 2017-October 10, 2024. PDAC was confirmed by histology. Obesity is here defined as body mass index (BMI) >25. Comparisons were based on the Low BMI (BMI < 25) vs. High BMI (BMI ≥ 25). Associations between groups were analyzed by Chi-square tests, t-tests, and if needed, Fisher’s exact test using R programming version 4.4.1 version (R Foundation, Vienna, Austria).

Results: In our study, there were 86 patients in the high BMI group and 76 in the low BMI group. White race was most common (n=149), and there were 90 males and 72 females in the study. Smoking status showed a significant difference between the groups (p = 0.005). There were less current (10) and former smokers (34) in the BMI ≥ 25 group. No significant difference was seen for Albumin, CA19-9. Hypertension was the most common comorbidity (n=101) followed by Type 2 diabetes mellitus (T2DM) (n=77). There is a significant difference in Type II Diabetes diagnosis between groups (p = 0.025). There is no significant difference seen for courses of chemotherapy (p=0.20). FOLFIRINOX therapy was more frequent in the BMI ≥ 25 group (44.2% vs. 34.2%). Complications, like thrombosis, infection, and GI bleeding were not significant different between the groups. Also, no changes for mortality, but a trend for hospice referral in the BMI < 25 group (odds ratio 0.46 (CI 0.22 to 0.93).

Discussion: Neither higher nor low BMI is a contraindication for systemic chemotherapy in patients with inoperable PDAC. Smoking is more common in patients with BMI < 25. In contrast, T2DM is more common in the BMI ≥ 25 group. Complications and mortality were not different between the groups, postulating that palliative chemotherapy is safe for both groups and PDAC patients should not have different approaches to treatment. Hospice referrals were more common in the BMI < 25 group, which may be from cognitive biases due to the more cachectic appearing phenotype.

Disclosures:
Ren Bryant indicated no relevant financial relationships.
Ruben Plentz indicated no relevant financial relationships.
Hannah Darnell indicated no relevant financial relationships.
Megan Hall indicated no relevant financial relationships.
Kristen McQuerry indicated no relevant financial relationships.
Kelsey Karnik indicated no relevant financial relationships.

Ren Chase. Bryant, DO¹, Ruben Plentz, MD¹, Hannah Darnell, DO¹, Megan E. Hall, MS², Kristen McQuerry, PhD², Kelsey Karnik, PhD². P4285 - No Impact of Body Mass Index (BMI) on Complications and Survival of Patients With Inoperable Pancreatic Ductal Adenocarcinoma (PDAC), ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.