Effect of abdominal aortic calcification on the prognosis and recurrence of colorectal cancer stages II–III: A retrospective cohort study

• Published in: International journal of colorectal disease Vol. 38; no. 1; p. 21
• Main Authors: Imaoka, Kouki, Shimomura, Manabu, Shimizu, Wataru, Akabane, Shintaro, Ohira, Masahiro, Imaoka, Yuki, Yoshinaka, Hisaaki, Ono, Kosuke, Mochizuki, Tetsuya, Matsubara, Keiso, Bekki, Tomoaki, Hattori, Minoru, Ohdan, Hideki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 21.01.2023
• Subjects: Colorectal Neoplasms - pathology; Gastroenterology; Hepatology; Humans; Internal Medicine; Liver Neoplasms - surgery; Medicine; Medicine & Public Health; Proctology; Prognosis; Proportional Hazards Models; Retrospective Studies; Surgery; Aortic calcification; Prognosis; Propensity score; Liver metastasis; Colorectal cancer
• ISSN: 1432-1262; 1432-1262
• DOI: 10.1007/s00384-023-04321-z

Purpose Abdominal aortic calcification (AAC) is a well-known risk marker for cardiovascular disease. However, its clinical effect on patients who underwent radical surgery for colorectal cancer (CRC) stages II–III is unclear. This study aimed to analyze the associations between AAC and prognosis of patients with stage II–III CRC. Methods To evaluate the effect of AAC on clinical outcomes, prognosis, and metastatic patterns of CRC, we analyzed 362 patients who underwent radical surgery for stage II–III CRC between 2010 and 2018. Results The high AAC group had significantly worse overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) after propensity score matching to adjust for differences in baseline characteristics of patients and tumors. In the multivariate Cox regression analyses, a high AAC was an independent risk factor for poor OS (hazard ratio [HR], 2.38; 95% confidence interval [CI], 1.23–4.59; p  = 0.01), poor CSS (HR, 5.22; 95% CI, 1.74–15.6; p  < 0.01), and poor RFS (HR, 1.83; 95% CI, 1.19–2.83; p  < 0.01). A high AAC was not associated with a risk of lung metastasis or local or peritoneal recurrence, but a risk for liver metastasis of CRC. Conclusion A high AAC showed a strong relationship with poor OS, CSS, and RFS after curative resection for stage II–III CRC. A high AAC was also associated with a risk for liver metastasis, which may worsen the prognosis in stage II–III CRC. AAC could be a new clinical tool for predicting the prognosis for patients in stage II–III CRC.