Fukushima Naoko, Masuda Takahiro, Furukawa Kenei, Tsuboi Kazuto, Takahashi Keita, Yuda Masami, Tsunematsu Masashi, Ikegami Toru, Yano Fumiaki, Eto Ken
Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
Department of Surgery, Fuji City General Hospital Fuji, Shizuoka 417-8567, Japan.
Oncol Lett. 2025 Feb 11;29(4):179. doi: 10.3892/ol.2025.14925. eCollection 2025 Apr.
Osteopenia is a potential prognostic factor in patients with cancer. Occult vertebral fracture, the most common complication of osteopenia, has recently been associated with cancer. The present study aimed to investigate the prognostic value of occult vertebral fracture after gastrectomy in patients with gastric cancer. The current retrospective study included 222 patients who underwent gastrectomy for gastric cancer between October 2013 and February 2023. Occult vertebral fracture was quantitatively evaluated using preoperative sagittal computed tomography images from the 11th thoracic to 5th lumbar vertebrae. Multivariate analysis showed that occult vertebral fracture (P<0.01, P=0.02, respectively), stage II or III (P<0.01, P<0.01, respectively), and R1 or R2 curability (P<0.01, P=0.03, respectively) were independent and significant predictors of disease-free and overall survival rates. Additionally, patients with both occult vertebral fracture and osteopenia had significantly lower disease-free and overall survival rates than those with either osteopenia or occult vertebral fracture (P<0.01, P<0.01, respectively). In conclusion, occult vertebral fracture may be considered a strong predictor of poor clinical outcomes in patients undergoing gastrectomy for gastric cancer.
骨质减少是癌症患者的一个潜在预后因素。隐匿性椎体骨折是骨质减少最常见的并发症，最近已被证实与癌症有关。本研究旨在探讨隐匿性椎体骨折对胃癌患者胃切除术后的预后价值。本项回顾性研究纳入了2013年10月至2023年2月期间因胃癌接受胃切除术的222例患者。使用术前从第11胸椎至第5腰椎的矢状位计算机断层扫描图像对隐匿性椎体骨折进行定量评估。多因素分析显示，隐匿性椎体骨折（分别为P<0.01，P=0.02）、II期或III期（分别为P<0.01，P<0.01）以及R1或R2可切除性（分别为P<0.01，P=0.03）是无病生存率和总生存率的独立且显著的预测因素。此外，同时患有隐匿性椎体骨折和骨质减少的患者的无病生存率和总生存率显著低于仅患有骨质减少或隐匿性椎体骨折的患者（分别为P<0.01，P<0.01）。总之，隐匿性椎体骨折可被视为胃癌胃切除术后患者临床预后不良的一个有力预测因素。
