术前骨质疏松是胃癌患者行胃切除术死亡的危险因素。

Preoperative Osteopenia Is a Risk Factor for Death in Patients Undergoing Gastrectomy for Gastric Cancer.

机构信息

Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan

Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

出版信息

Anticancer Res. 2023 Aug;43(8):3665-3672. doi: 10.21873/anticanres.16548.

DOI:10.21873/anticanres.16548

PMID:37500136

Abstract

BACKGROUND/AIM: Preoperative osteopenia, defined as low bone mineral density (BMD), has been reported as a prognostic factor in patients with digestive tract cancers. However, the correlation between preoperative osteopenia and the prognosis of gastric cancer (GC) remains unclear. The aim of this study was to reveal the importance of preoperative osteopenia as a prognostic factor in patients undergoing gastrectomy for GC.

PATIENTS AND METHODS

We enrolled 251 patients who had undergone curative surgery for histopathologically diagnosed gastric adenocarcinoma from January 2008 to December 2012. BMD was calculated as the average pixel density (Hounsfield units) within a circle of the mid-vertebral core at the bottom of the 11th thoracic vertebra on preoperative computed tomography.

RESULTS

Osteopenia had a high area under the curve and predictive value for both overall survival (OS) and disease-specific survival (DSS). The study cohort was categorized into an osteopenia group and non-osteopenia group based on the optimal BMD cutoff values for OS (157.5) and DSS (195) determined by receiver operating characteristic analysis. The multivariate analysis revealed that OS (hazard ratio=3.607, p<0.001) and DSS (hazard ratio=2.797, p=0.03) were significantly worse in patients with than without preoperative osteopenia.

CONCLUSION

Preoperative osteopenia is associated with poor OS and DSS in patients undergoing gastrectomy for GC.

摘要

背景/目的：术前骨质疏松症（定义为低骨密度）已被报道为消化道癌症患者的预后因素。然而，术前骨质疏松症与胃癌（GC）预后之间的相关性尚不清楚。本研究旨在揭示术前骨质疏松症作为接受 GC 胃切除术患者的预后因素的重要性。

患者和方法

我们纳入了 2008 年 1 月至 2012 年 12 月期间因组织病理学诊断为胃腺癌而行根治性手术的 251 例患者。BMD 通过术前 CT 计算第 11 胸椎底部中间椎体核心的圆形内的平均像素密度（Hounsfield 单位）来计算。

结果

骨质疏松症对总生存期（OS）和疾病特异性生存期（DSS）均具有较高的曲线下面积和预测值。根据 OS（157.5）和 DSS（195）的最佳 BMD 截止值，通过接收者操作特征分析，将研究队列分为骨质疏松组和非骨质疏松组。多变量分析显示，与术前无骨质疏松症的患者相比，OS（风险比=3.607，p<0.001）和 DSS（风险比=2.797，p=0.03）的 OS 和 DSS 明显更差。