Yamahata Yuto, Gocho Takeshi, Furukawa Kenei, Haruki Koichiro, Onda Shinji, Shirai Yoshihiro, Tsunematsu Masashi, Taniai Tomohiko, Yanagaki Mitsuru, Matsumoto Michinori, Hamura Ryoga, Okui Norimitsu, Tanji Yoshiaki, Ikegami Toru
Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Surg Today. 2025 Apr;55(4):544-551. doi: 10.1007/s00595-024-02922-x. Epub 2024 Aug 20.
Abdominal aortic calcification (AAC), an indicator of systemic arteriosclerosis, is associated with short- and long-term outcomes in malignancies. We investigated the prognostic impact of AAC in patients who underwent hepatectomy for intrahepatic cholangiocarcinoma (IHCC).
The study cohort comprised 46 patients who underwent hepatectomy for IHCC between January 2008 and September 2020. The AAC volume measured by preoperative computed tomography was used to construct a model of the calcified segment from the renal artery to the common iliac artery bifurcation. We investigated the relationship between AAC and the long-term outcomes. The AAC volume cutoff value was calculated from a receiver-operating characteristic curve based on the three-year survival.
According to our cutoff AAC volume of 3,700 mm, 11 patients (24%) had high AAC volumes. The high-AAC group was significantly older than the low-AAC group (73 vs. 62 years old, p < 0.01). A multivariate analysis of the cancer-specific survival showed that a high serum carbohydrate antigen 19-9 concentration (hazard ratio [HR] 5.57, p = 0.01), high AAC volume (HR 3.03, p = 0.04), and [high?] T3 or T4 levels (HR 9.05, p < 0.01) were independently associated with a poor prognosis.
AAC is a useful predictor of the oncological prognosis in patients undergoing hepatectomy for IHCC.
腹主动脉钙化（AAC）是全身动脉硬化的一个指标，与恶性肿瘤的短期和长期预后相关。我们研究了AAC对接受肝内胆管癌（IHCC）肝切除术患者的预后影响。
研究队列包括2008年1月至2020年9月期间接受IHCC肝切除术的46例患者。术前计算机断层扫描测量的AAC体积用于构建从肾动脉到髂总动脉分叉的钙化节段模型。我们研究了AAC与长期预后之间的关系。根据基于三年生存率的受试者工作特征曲线计算AAC体积临界值。
根据我们3700立方毫米的AAC体积临界值，11例患者（24%）的AAC体积较高。高AAC组明显比低AAC组年龄大（73岁对62岁，p<0.01）。对癌症特异性生存的多因素分析表明，高血清糖类抗原19-9浓度（风险比[HR]5.57，p=0.01）、高AAC体积（HR 3.03，p=0.04）以及[高？]T3或T4水平（HR 9.05，p<0.01）与预后不良独立相关。
AAC是接受IHCC肝切除术患者肿瘤预后的一个有用预测指标。
