The Goddard score for emphysema predicts the postoperative prognosis in pancreatic cancer.

PURPOSE: Chronic inflammation contributes to carcinogenesis and pulmonary emphysema is characterized by chronic pulmonary inflammation. We hypothesized that the severity of emphysema, quantitatively assessed using the Goddard score (GS), correlates with outcomes following surgical treatment for pancreatic cancer.

METHODS

We retrospectively analyzed 191 patients who underwent surgery for pancreatic cancer between 2013 and 2022. GS was assessed using routine preoperative computed tomography. Univariate and multivariate analyses were performed to evaluate the impact of GS on oncological outcomes.

RESULTS

A high GS (≥ 7) was identified in 46 (24.1%) patients, who were significantly older and had a lower body mass index than patients with a low GS. In the multivariate analysis, a high GS emerged as an independent predictor of both a worse disease-free survival (DFS) (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.06-2.36; p = 0.01) and worse overall survival (OS) (HR, 1.80; 95% CI, 1.09-2.97; p = 0.02). Other independent risk factors included a poor DFS, sarcopenia, lymph node metastasis, poor tumor differentiation, poor OS, poor tumor differentiation, lack of adjuvant chemotherapy, and postoperative complications.

CONCLUSION

The GS, a simple radiological index of emphysema, may serve as a novel preoperative prognostic indicator in patients undergoing pancreatic cancer surgery.