Pancreatic volume is one of the independent prognostic factors for resectable pancreatic ductal adenocarcinomas

• Published in: Journal of Hepato-Biliary-Pancreatic Sciences Vol. 23; no. 8; pp. 472 - 479
• Main Authors: Fukumoto, Tsuyoshi, Watanabe, Toshihiro, Hirai, Ichiro, Kimura, Wataru
• Format: Journal Article
• Language: English
• Published: Japan Blackwell Publishing Ltd 01.08.2016; Wiley; Wiley Subscription Services, Inc
• Subjects: Adenocarcinoma; Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Atrophy; Body Surface Area; Carcinoma, Pancreatic Ductal; Carcinoma, Pancreatic Ductal - mortality; Carcinoma, Pancreatic Ductal - pathology; Carcinoma, Pancreatic Ductal - surgery; Cause of Death; Cohort Studies; CT volumetry; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Organ Size; Pancreas; Pancreas - anatomy & histology; Pancreas - surgery; Pancreatectomy; Pancreatectomy - methods; Pancreatectomy - mortality; Pancreatic ductal adenocarcinoma; Pancreatic Neoplasms; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy; Pancreaticoduodenectomy - methods; Pancreaticoduodenectomy - mortality; Predictive Value of Tests; Prognosis; Retrospective Studies; Risk Assessment; Survival Analysis; Treatment Outcome; Atrophy; Pancreatic ductal adenocarcinoma; CT volumetry
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.365

Background It is well known that pancreatic ductal adenocarcinoma (PDAC) is accompanied with pancreatic atrophy and fibrosis. We previously reported the correlation between pancreatic volume and body surface area (BSA) and significant reduction of BSA‐adjusted pancreatic volume in pancreatic cancer patients. We evaluated potential correlation between BSA‐adjusted pancreatic volume and PDAC prognosis. Methods The study subjects were 48 pancreatic cancer patients received pancreatectomy at our department from June 2006 to September 2012. Pancreatic volumetry was retrospectively performed using the images obtained from multidetector computed tomography before the surgery. BSA‐adjusted pancreatic volumes were calculated and analyzed for potential correlation with the prognosis. Results Average BSA‐adjusted pancreatic volume among 48 cases was 35.4 ± 11.9 ml/m2. Types of surgery included 24 cases with pancreaticoduodenectomy and 24 cases with distal pancreatectomy. The cases with BSA‐adjusted pancreatic volume less than 40 ml/m2 had significantly poorer prognosis compared to the cases of 40 ml/m2 and greater (3‐year survival rate: 32.4% vs. 64.3%). Statistical analysis identified four prognosis factors, i.e. BSA‐adjusted pancreatic volume less than 40 ml/m2, postoperative adjuvant chemotherapy, lymph node metastasis and lymphatic invasion. Conclusions This study demonstrated BSA‐adjusted pancreatic volume as a prognosis factor for PDAC and the volume of 40 ml/m2 is considered to be the cutoff value. Highlight Pancreatic ductal adenocarcinoma (PDAC) is accompanied with pancreatic atrophy, but the correlation between preoperative pancreatic volume measured by CT volumetry and PDAC prognosis has not been elucidated. Fukumoto and colleagues demonstrated body surface area‐adjusted pancreatic volume to be a prognostic factor for PDAC with a cutoff value of 40 ml/m2.