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World Journal of Surgery

, Volume 43, Issue 3, pp 920–928 | Cite as

Bone Mineral Density as a Risk Factor for Patients Undergoing Surgery for Hepatocellular Carcinoma

  • Yosuke Miyachi
  • Toshimi KaidoEmail author
  • Siuan Yao
  • Hisaya Shirai
  • Atsushi Kobayashi
  • Yuhei Hamaguchi
  • Naoko Kamo
  • Shintaro Yagi
  • Shinji Uemoto
Original Scientific Report
  • 80 Downloads

Abstract

Background

We have reported the impact of sarcopenia and body composition on patients undergoing hepatectomy for hepatocellular carcinoma (HCC). However, the impact of bone mineral density (BMD) on outcomes after hepatectomy for HCC and correlation with other parameters including sarcopenia are unclear.

Methods

We retrospectively analyzed 465 patients who underwent primary hepatectomy for HCC between April 2005 and March 2015. We analyzed the plain CT images at the level of the eleventh thoracic vertebra with the region of interest and defined as preoperative BMD.

Results

In this cohort, male (n = 367) and female (n = 98) patients showed significant heterogeneity in age, body composition markers, tumor factors, peri-operative parameters and so on. The median preoperative BMD in male and female patients was 155 and 139 HU, respectively (P = 0.005). BMD was negatively correlated with age in female (r = −0.590, P < 0.001) and intramuscular adipose tissue content in both male and female (r = −0.332 and −0.359, respectively, P < 0.001). For males, BMD < 160 HU was associated with worse cancer-specific survival post-hepatectomy (P = 0.015). In contrast, females were not (P = 0.135). For male patients, multivariate analysis identified low BMD as an independent risk factor for death (hazard ratio 1.720, 95% confidence interval 1.038–2.922, P = 0.035) after hepatectomy for HCC.

Conclusion

Preoperative low BMD was an independent risk factor for cancer-specific mortality after hepatectomy for HCC.

Abbreviation

AFP

Alpha-fetoprotein

AUC

Area under the curve

BMD

Bone mineral density

CI

Confidence interval

CT

Computed tomography

DXA

Dual-energy X-ray absorptiometry

HBs Ag

Hepatitis B virus antigen

HCC

Hepatocellular carcinoma

HCV Ab

Hepatitis C virus antibody

HU

Hounsfield unit

IMAC

Intramuscular adipose tissue content

IQR

Interquartile range

PMI

Psoas muscle index

ROC

Receiver operating characteristic

ROI

Region of interest

SD

Standard deviation

Th11

Eleventh thoracic vertebra

VSR

Visceral-to-subcutaneous adipose tissue ratio

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Yosuke Miyachi
    • 1
  • Toshimi Kaido
    • 1
    Email author
  • Siuan Yao
    • 1
  • Hisaya Shirai
    • 1
  • Atsushi Kobayashi
    • 1
  • Yuhei Hamaguchi
    • 1
  • Naoko Kamo
    • 1
  • Shintaro Yagi
    • 1
  • Shinji Uemoto
    • 1
  1. 1.Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan

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