Abstract
Purpose
The aim of this study is to evaluate the correlation between bone mineral density (BMD) and other body composition markers, as well as, the impact of preoperative BMD on the surgical outcomes after resection of pancreatic cancer.
Methods
This retrospective study included 275 patients who underwent surgical resection of pancreatic cancer in our institute between 2003 and 2016. Patients were divided according to BMD into low and normal groups and their postoperative outcomes were compared. Risk factors for mortality and tumor recurrence were also evaluated.
Results
Patients with low BMD were older (P < 0.001), had a higher intramuscular adipose tissue content (P = 0.011) and higher visceral fat area (P = 0.003). The incidence of postoperative pancreatic fistula (POPF) (grade ≥ B) was higher in the low BMD group. No significant difference was observed between the two groups regarding overall survival and recurrence-free survival and low BMD was not a risk factor for mortality or tumor recurrence after resection of pancreatic cancer.
Conclusion
A low preoperative BMD was not found to be a risk factor for mortality or tumor recurrence after resection of pancreatic cancer; however, it was associated with a higher incidence of clinically relevant POPF.
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Abbreviations
- BMI:
-
Body mass index
- BMD:
-
Bone mineral density
- CA 19.9:
-
Carbohydrate antigen 19.9
- CT:
-
Computed tomography
- DP:
-
Distal pancreatectomy
- DXA:
-
Dual-energy X-ray absorptiometry
- HR:
-
Hazard ratio
- HCC:
-
Hepatocellular carcinoma
- HU:
-
Hounsfield unit
- IMAC:
-
Intramuscular adipose tissue content
- IQR:
-
Interquartile range
- mGPS:
-
Modified Glasgow prognostic score
- NAC:
-
Neoadjuvant chemotherapy
- OS:
-
Overall survival
- PD:
-
Pancreaticodudonectomy
- PMI:
-
Psoas muscle index
- PNI:
-
Prognostic nutritional index
- POPF:
-
Postoperative pancreatic fistula
- RFS:
-
Recurrence-free survival
- SMI:
-
Skeletal mass index
- UICC:
-
Union for International Cancer Control
- VSR:
-
Visceral to subcutaneous adipose tissue area ratio
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Sharshar, M., Kaido, T., Shirai, H. et al. Impact of the preoperative bone mineral density on the outcomes after resection of pancreatic cancer. Surg Today 50, 757–766 (2020). https://doi.org/10.1007/s00595-019-01954-y
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DOI: https://doi.org/10.1007/s00595-019-01954-y