Predictive Value of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve for Survival in Patients with Esophageal Cancer Following Esophagectomy.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-08-29 DOI:10.1007/s12029-025-01296-8

Xiaoqin Chen, Xiongmu Tan, Yushang Yang, Linyan Huang, Simeng Wang, Yinqiu Wang, Xueting Pang, Shenmei Liu, Yong Yuan, Liqing Peng

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引用次数: 0

Abstract

Objective: This study aimed to assess the predictive value of CT-FFR on survival in patients with esophageal carcinoma (EC) after esophagectomy.

Methods: Five hundred and eighty patients with EC who had coronary computed tomography angiography (CCTA) and esophagectomy from January 2012 to September 2023 were included in this study. The lesion-specific fractional flow reserve (FFR) was derived from CCTA. The 580 post-esophagectomy EC patients were divided into two groups: CT-FFR > 0.80 (n = 406) and CT-FFR ≤ 0.80 (n = 174). Propensity score matching (PSM) analysis was used to control for confounding factors. Overall survival (OS) was estimated using Kaplan-Meier curves and Cox proportional hazards models based on univariate and multivariate screening of variables.

Results: The CT-FFR ≤ 0.80 group had a higher proportion of males, more patients with coronary artery calcium score (CACS) ≥ 100, lower tumor stages, a higher proportion of patients receiving neoadjuvant therapy, and a higher proportion of patients undergoing full laparoscopy surgery (all p < 0.05). After PSM, the two matched groups of patients had similar characteristics. In our Cox regression model, CT-FFR ≤ 0.80 was an independent factor associated with OS (HR: 1.37; 95% CI: 1.038-1.818; p = 0.026) compared to CT-FFR > 0.80. The results after PSM still showed that CT-FFR ≤ 0.80 was an independent factor associated with OS (HR: 1.43; 95% CI: 1.022-2.009; p = 0.037) compared to CT-FFR > 0.80.

Conclusion: CT-FFR is found to be a valuable imaging marker in predicting outcomes of EC patients following esophagectomy. Specifically, a CT-FFR ≤ 0.80 is associated with poorer survival outcomes in EC patients. This underscores the incremental prognostic value of CT-FFR in predicting survival outcomes among post-esophagectomy patients.

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食管癌切除术后冠状动脉ct血管造影衍生的分流储备对患者生存的预测价值。

目的：本研究旨在评估CT-FFR对食管癌（EC）患者食管切除术后生存的预测价值。方法：本研究纳入2012年1月至2023年9月580例行冠状动脉ct血管造影（CCTA）和食管切除术的EC患者。病变特异性分数血流储备（FFR）由CCTA得出。580例食管切除术后EC患者分为两组：CT-FFR≥0.80 （n = 406）和CT-FFR≤0.80 （n = 174）。采用倾向评分匹配（PSM）分析控制混杂因素。基于单变量和多变量筛选，使用Kaplan-Meier曲线和Cox比例风险模型估计总生存期（OS）。结果：CT-FFR≤0.80组男性比例较高，冠状动脉钙评分(CACS)≥100的患者较多，肿瘤分期较低，接受新辅助治疗的患者比例较高，接受全腹腔镜手术的患者比例较高（p均为0.80）。PSM后的结果仍然显示，CT-FFR≤0.80是与OS相关的独立因素（HR: 1.43; 95% CI: 1.022-2.009; p = 0.037），而CT-FFR≤0.80。结论：CT-FFR是预测食管切除术后EC患者预后的有价值的影像学指标。具体而言，CT-FFR≤0.80与EC患者较差的生存结果相关。这强调了CT-FFR在预测食管切除术后患者生存结果方面的增量预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.