Coronary artery calcification is not associated with survival in advanced gastric and gastroesophageal junction cancer: a secondary analysis of the EXPAND trial.
Hans-Jonas Meyer, Tihomir Dermendzhiev, Paul-Philipp Jacobs et al.
✦ AI-curated · Sources linked
In 30 seconds
This secondary analysis of baseline CT images from the phase III EXPAND trial assessed whether coronary artery calcification (CAC) predicted overall survival in 785 patients with unresectable locally advanced or metastatic gastric or gastroesophageal junction cancer. CAC was scored semiquantitatively using the Weston method. In univariable analysis, CAC presence versus absence was not significantly associated with mortality (HR 1.08, 95% CI 0.92-1.26, p = 0.34); analysis of CAC as a continuous score was also not significant. The findings do not support CAC as a relevant prognostic marker in this population receiving first-line chemotherapy.
Key findings
- 337 patients (42.9%) had no visible coronary artery calcification.
- CAC presence versus absence was not significantly associated with survival (HR:1.08, 95% CI: 0.92-1.26, p = 0.34).
- CAC analysed as a continuous score was also not significantly associated with survival (HR: 0.99, 95% CI: 0.96-1.02, p = 0.74).
- Male patients had higher median CAC scores than female patients (1 versus 0, p < 0.0001).
Why it matters
CAC is visible on routine staging CT, and its prognostic value has been reported in other cancer settings. In this analysis, however, CAC did not identify differences in overall survival among patients with advanced gastric or gastroesophageal junction cancer. This cautions against assuming that a CT finding has the same prognostic meaning across cancer types.
What to keep in mind
This was a secondary analysis of baseline CT images from a trial, rather than a study designed primarily to evaluate CAC. The reported survival associations are univariable; the abstract does not provide adjusted effect estimates.