{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:40:54Z","timestamp":1792460454137,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contemporary rectal cancer treatment pathways remain predominantly guided by tumour\u2010related characteristics, including stage and histopathology, with comparatively limited objective assessment of physiological reserve for treatment planning. Aortic calcification represents a potential imaging biomarker reflecting systemic vascular disease, chronic inflammation and physiological reserve. We evaluated computed tomography (CT)\u2010derived abdominal aortic calcification as a prognostic imaging biomarker for postoperative outcomes and long\u2010term survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using the prospectively maintained Australian Comprehensive Cancer Outcomes and Research Database (ACCORD) of rectal cancer patients treated between 2013 and 2022. Pre\u2010treatment staging CT was subjected to semi\u2010automated volumetric quantification of calcium using 3D Slicer software. Calcification volume was assessed segmentally at vertebral levels L1\u2013L4 and at the iliac vessels. Primary outcomes were major postoperative complications (Clavien\u2013Dindo\u2009\u2265\u2009III) and overall survival. Cox proportional hazards modelling was performed using a prespecified parsimonious multivariable model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 174 patients were included in the analysis. Increasing calcification burden demonstrated no statistically significant association with major postoperative complications (OR 1.09 per 1000\u2010unit increase; 95% CI 0.99\u20131.19;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07). Increasing calcification independently predicted worse 5\u2010year survival after multivariable adjustment (HR 1.17 per 1000\u2010unit increase ([CI 1.08\u20131.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001]). Kaplan\u2013Meier analyses showed separation between calcification groups, although dichotomised analyses did not reach statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Aortic calcification independently predicts long\u2010term survival following rectal cancer surgery but not short\u2010term postoperative complications. Quantitative CT\u2010derived calcification assessment may provide a rapid, objective imaging biomarker that reflects physiological reserve and represents a potential adjunct to future risk stratification pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.71025","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:20:38Z","timestamp":1792459238000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computed Tomography\u2010Derived Abdominal Aortic Calcification Independently Predicts Survival in Rectal Cancer Surgery: A Retrospective Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6741-7562","authenticated-orcid":false,"given":"Michael","family":"Rouse","sequence":"first","affiliation":[{"name":"Department of Surgery University of Melbourne  Melbourne Australia"},{"name":"Department of Surgery Western Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwa","family":"Hadi","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0199-4624","authenticated-orcid":false,"given":"Yumna","family":"Kaleem","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Melbourne  Melbourne Australia"},{"name":"Department of Surgery Western Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9134-7509","authenticated-orcid":false,"given":"Alex","family":"Besson","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Melbourne  Melbourne Australia"},{"name":"Department of Surgery Western Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6341-257X","authenticated-orcid":false,"given":"Fiona","family":"Reid","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Melbourne  Melbourne Australia"},{"name":"Department of Surgery Western Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7230-149X","authenticated-orcid":false,"given":"Justin M.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Melbourne  Melbourne Australia"},{"name":"Department of Surgery Western Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2025.0050"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2025.102570"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12816"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2016.03.007"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010020\u201007189\u20107"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14795"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304\u2010023\u201001630\u20104"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010017\u20102949\u20107"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010023\u201004321\u2010z"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14020146"},{"issue":"4","key":"e_1_2_13_12_1","first-page":"415","article-title":"Does Calcium Score in Great Pelvic Vessels Predict Colorectal Anastomotic Leakage? A Prospective Study of One Hundred Anastomoses","volume":"79","author":"Norooz M. T.","year":"2016","journal-title":"Acta Gastro\u2010Enterologica Belgica"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyab196"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.52198\/21.STI.39.CR1479"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2019.11.023"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.37349\/ec.2025.101279"},{"key":"e_1_2_13_17_1","unstructured":"Z.Ilyas A.Saleem D.Suter et\u00a0al. \u201cAACLiteNet: A Lightweight Model for Detection of Fine\u2010Grained Abdominal Aortic Calcification \u201d2024 https:\/\/arxiv.org\/abs\/2409.17203."}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.71025","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.71025","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.71025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:20:40Z","timestamp":1792459240000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.71025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":16,"alternative-id":["10.1111\/ans.71025"],"URL":"https:\/\/doi.org\/10.1111\/ans.71025","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"assertion":[{"value":"2026-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ans.71025"}}