title: Pancreatic volume is one of the independent prognostic factors for resectable pancreatic ductal adenocarcinomas.
abstract: 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/m(2) . 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/m(2) had significantly poorer prognosis compared to the cases of 40 ml/m(2) 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/m(2) , 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/m(2) is considered to be the cutoff value.
authors.affiliation: First Department of Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata City, Yamagata, 990-9585, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Fukumoto
authors.affiliation: First Department of Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata City, Yamagata, 990-9585, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: First Department of Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata City, Yamagata, 990-9585, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hirai
authors.affiliation: First Department of Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata City, Yamagata, 990-9585, Japan. wkimura@med.id.yamagata-u.ac.jp.
authors.forename: Wataru
authors.initials: W
authors.lastname: Kimura
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D001830:Body Surface Area; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D010179:Pancreas / Q000033:anatomy & histology* / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Atrophy; CT volumetry; Pancreatic ductal adenocarcinoma