Kamada Teppei, Furukawa Kenei, Takahashi Junji, Nakashima Keigo, Nakaseko Yuichi, Suzuki Norihiko, Yoshida Masashi, Ohdaira Hironori, Ikegami Toru, Suzuki Yutaka
Department of Surgery International University of Health and Welfare Hospital Nasushiobara Japan.
Department of Surgery The Jikei University School of Medicine Minato-ku Japan.
Ann Gastroenterol Surg. 2021 Jul 26;5(6):832-843. doi: 10.1002/ags3.12491. eCollection 2021 Nov.
We examined the prognostic impact of osteopenia on the long-term outcomes of patients with colorectal cancer after laparoscopic colectomy along with other nutritional factors, including sarcopenia or the Glasgow Prognostic Score.
This retrospective cohort study analyzed the data of 230 patients with stage Ⅰ-Ⅲ colorectal cancers who underwent surgical resection between November 2010 and December 2015. Osteopenia and sarcopenia were evaluated by measuring the average pixel density in the mid-vertebral core of the 11th thoracic vertebra on enhanced computed tomography and the psoas muscle mass area at the third lumbar vertebra, respectively. The overall survival and disease-free survival rates were analyzed using Cox proportional hazards model and Kaplan-Meier curves with the log-rank test.
Osteopenia was identified in 43 patients (18.7%). Univariate analysis showed that the disease-free survival rate was significantly worse in patients with stage II-III cancers, vascular invasion, carcinoembryonic antigen (CA) >5.0 ng/mL, CA19-9 > 37.0 U/mL, sarcopenia, and osteopenia (all < .01). Multivariate analysis revealed that stage II-III cancers ( = .01), vascular invasion ( = .01), carcinoembryonic antigen >5.0 ( < .01), and osteopenia ( < .01) were significant independent disease-free survival predictors. In univariate analysis, the overall survival rate significantly decreased in patients with stage II-III cancers ( = .03), carcinoembryonic antigen >5.0 ( < .01), CA19-9 > 37.0 ( < .01), sarcopenia ( < .01), and osteopenia ( < .01). Multivariate analysis indicated that carcinoembryonic antigen >5.0 ( = .04), CA19-9 > 37.0 ( = .05), and osteopenia ( < .01) were significant independent predictors of overall survival.
Preoperative osteopenia could be a strong predictor of long-term outcomes in patients undergoing resection for colorectal cancer.
我们研究了骨量减少对腹腔镜结肠切除术后结直肠癌患者长期预后的影响，并探讨了其与其他营养因素的关系，包括肌肉减少症或格拉斯哥预后评分。
这项回顾性队列研究分析了2010年11月至2015年12月期间接受手术切除的230例Ⅰ-Ⅲ期结直肠癌患者的数据。分别通过增强计算机断层扫描测量第11胸椎椎体中部核心区域的平均像素密度以及通过测量第三腰椎椎体的腰大肌质量面积来评估骨量减少和肌肉减少症。使用Cox比例风险模型和带有对数秩检验的Kaplan-Meier曲线分析总生存率和无病生存率。
43例患者（18.7%）被诊断为骨量减少。单因素分析显示，Ⅱ-Ⅲ期癌症、血管侵犯、癌胚抗原（CA）>5.0 ng/mL、CA19-9>37.
