Abstract
PURPOSE: This study examined the impact of abdominal aortic calcification, a known risk factor for cardiovascular disease, on the prognosis of patients undergoing radical surgery for gastric cancer. METHODS: The effects of abdominal aortic calcification on clinical outcomes, prognosis, and recurrence patterns were analyzed in 516 patients who underwent radical surgery for gastric cancer between 2010 and 2017. RESULTS: After propensity score matching, patients with higher abdominal aortic calcification had significantly poorer overall survival (OS; P = 0.020), disease specific survival (DSS; P = 0.013), and recurrence-free survival (RFS; P = 0.017) than those with lower calcification levels. Multivariate Cox regression analysis identified a higher degree of abdominal aortic calcification as an independent risk factor for poor OS (hazard ratio, 2.57; 95% confidence interval, 1.56-4.22; P < 0.001), DSS (hazard ratio, 4.32; 95% confidence interval, 1.84-10.12; P < 0.001) and RFS (hazard ratio, 2.63; 95% confidence interval, 1.60-4.33; P < 0.001). High abdominal aortic calcification was also a risk factor for peritoneal dissemination recurrence in gastric cancer. CONCLUSION: A high degree of abdominal aortic calcification was linked to poor prognosis and might increase peritoneal dissemination recurrence following curative resection for gastric cancer. Thus, abdominal aortic calcification may serve as a novel clinical tool for predicting the prognosis of patients with gastric cancer.