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Prognostic Significance of Preoperative Osteopenia in Patients Undergoing Esophagectomy for Esophageal Cancer

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A Correction to this article was published on 11 August 2021

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Abstract

Background

Osteopenia, which exhibits low bone mineral density (BMD), has been linked to sarcopenia and recently reported as a prognostic factor in various cancers. However, the prognostic significance of osteopenia in esophageal cancer remains unclear. Hence, this study aimed to clarify the impact of osteopenia on the prognosis of patients undergoing esophagectomy for esophageal cancer.

Methods

We included 229 patients who underwent esophagectomy. BMD was calculated as the average pixel density (Hounsfield unit) within a circle in midvertebral core at the 11th thoracic vertebra on preoperative computed tomography. We then divided the patients into the Osteopenia group (n = 159) and the Non-Osteopenia group (n = 70) according to the optimal cutoff value obtained from the receiver operating characteristic curve. Their clinicopathological data, prognosis, and recurrence were analyzed.

Results

The mean age was significantly older in the Osteopenia group (p = 0.047). The Osteopenia group had significantly worse overall survival (OS) and relapse-free survival (RFS) than the Non-Osteopenia group (p = 0.001 and p = 0.012, respectively). Multivariate analysis revealed osteopenia was an independent prognostic factor for OS (p < 0.001; hazard ratio [HR], 2.243; 95% confidence interval [CI], 1.422–3.538) and RFS (p = 0.008; HR, 1.739; 95% CI, 1.154–2.620). In logistic regression model, advanced age and cStage III-IV were independent risk factors for preoperative osteopenia.

Conclusions

Preoperative osteopenia is associated with poor survival and recurrence in patients undergoing esophagectomy for esophageal cancer.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Keita Takahashi, Katsunori Nishikawa, Kenei Furukawa, Yuichiro Tanishima, Yoshitaka Ishikawa, Takanori Kurogochi, Masami Yuda, Yujiro Tanaka, Akira Matsumoto, Norio Mitsumori & Toru Ikegami

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  1. Keita Takahashi
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  2. Katsunori Nishikawa
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Correspondence to Keita Takahashi.

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This study protocol was approved by the Institutional Review Board of the Jikei University School of Medicine (28–321).

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The original online version of this article has been revised: Table 3 was corrected.

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Takahashi, K., Nishikawa, K., Furukawa, K. et al. Prognostic Significance of Preoperative Osteopenia in Patients Undergoing Esophagectomy for Esophageal Cancer. World J Surg 45, 3119–3128 (2021). https://doi.org/10.1007/s00268-021-06199-w

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