Abdominal aortic calcification volume as a preoperative prognostic predictor for pancreatic cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 55; no. 1; pp. 70 - 77
• Main Authors: Yamada, Yuta, Furukawa, Kenei, Haruki, Koichiro, Okui, Norimitsu, Shirai, Yoshihiro, Tsunematsu, Masashi, Yanagaki, Mitsuru, Yasuda, Jungo, Onda, Shinji, Ikegami, Toru
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.01.2025
• Subjects: Aged; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - pathology; Aortic Diseases - diagnostic imaging; Aortic Diseases - mortality; Aortic Diseases - pathology; Aortic Diseases - surgery; Chemotherapy, Adjuvant; Female; Humans; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Middle Aged; Operative Time; Original Article; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Preoperative Period; Prognosis; Retrospective Studies; Risk Factors; Sarcopenia - complications; Sarcopenia - diagnostic imaging; Surgery; Surgical Oncology; Survival Rate; Tomography, X-Ray Computed; Vascular Calcification - diagnostic imaging; Vascular Calcification - mortality; Vascular Calcification - pathology; Chronic inflammation; Pancreatic cancer; Prognostic score; Atherosclerosis; Abdominal aortic calcification
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02882-2

Purpose Atherosclerosis and cancer may progress through common pathological factors. This study was performed to investigate the association between the abdominal aortic calcification (AAC) volume and outcomes following surgical treatment for pancreatic cancer. Methods The subjects of this retrospective study were 194 patients who underwent pancreatic cancer surgery between 2007 and 2020. The AAC volume was assessed through routine preoperative computed tomography. Univariate and multivariate analyses were performed to evaluate the impact of the AAC volume on oncological outcomes. Results A higher AAC volume (≥ 312 mm 3 ) was identified in 66 (34%) patients, who were significantly older and had a higher prevalence of diabetes and sarcopenia. Univariate analysis revealed several risk factors for overall survival (OS), including male sex, an AAC volume ≥ 312 mm3, elevated carbohydrate antigen 19–9, prolonged operation time, increased intraoperative bleeding, lymph node metastasis, poor differentiation, and absence of adjuvant chemotherapy. Multivariate analysis identified an AAC volume ≥ 312 mm3, prolonged operation time, lymph node metastasis, poor differentiation, and absence of adjuvant chemotherapy as independent OS risk factors. The OS rate was significantly lower in the high AAC group than in the low AAC group. Conclusion The AAC volume may serve as a preoperative prognostic indicator for patients with pancreatic cancer.