Abstract
Background: This study aimed to reveal if preoperative CT-based measurements of abdominal composition profile may predict the risk of major morbidity and mortality after curative resection for pancreatic cancer. Methods: CT-Images of 120 patients, curatively resected for pancreatic cancer were retrospectively analysed. Total Psoas Area (TPA) as a measure of sarcopenia, Pancreatic Attenuation Index (PAI) as a measure of soft pancreatic tissue, pancreatic duct diameter, amount of visceral and subcutaneous fat were quantitatively determined. Primary endpoint was 60-day mortality. Secondary endpoints included rate of pancreatic fistula and overall complications. Results: There were 74 PD, 21 DP and 25 TP. Mean age was 68 years, mean BMI 24.9 kg/sqm. 29/120 patients were sarcopenic according to TPA, 17 of them had sarcopenic obesity. POPF rate was 15%, major complications Dindo>3 25%, mortality 2.5%. None of the studied CT-parameters were determinants of mortality. Sarcopenic obesity, low PAI <65 HU and pancreatic duct diameter <3mm were the sole independent risk factors for POPF and Major morbidity in the multivariate analysis. Conclusion: Preoperative CT allows easy quantitative assessment of sarcopenic obesity, pancreatic texture and duct diameter and thus may reliably identify high-risk patients with respect to postoperative complications following resection of pancreatic cancer.
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