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Impact of the preoperative bone mineral density on the outcomes after resection of pancreatic cancer

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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Fig. 1
Fig. 2

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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Correspondence to Toshimi Kaido.

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The authors declare no conflicts of interest in association with the present study.

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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 (2020). https://doi.org/10.1007/s00595-019-01954-y

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Keywords

  • Bone mineral density
  • Sarcopenia
  • Pancreatic cancer
  • Survival
  • Recurrence