Prognostic significance of preoperative osteopenia on outcomes after gastrectomy for gastric cancer

Abstract

Aim Osteopenia, characterized by low bone mineral density, is a potential prognostic factor for patients with cancer. The aim of this study was to clarify the impact of preoperative osteopenia in patients with gastric cancer (GC) after gastrectomy. Methods We included 224 patients with GC who underwent gastrectomy between August 2013 and May 2022. Osteopenia was evaluated by measuring the pixel density in the mid‐vertebral core of the 11th thoracic vertebra using computed tomography. Results Osteopenia was identified in 68 patients (30%). The osteopenia group had significantly worse overall survival (OS) and disease‐free survival (DFS) than the non‐osteopenia group ( P < .01, P < .01, respectively). The postoperative hospital stay was significantly longer, and the occurrence of postoperative complications (Clavien‐Dindo grade ≥ III) was significantly higher in the osteopenia group ( P = .04, P < .01, respectively). In multivariate analysis, osteopenia ( P < .01), stage ≥II ( P < .01), and R1 or R2 curability ( P < .01) were independent and significant predictors of DFS. Additionally, osteopenia ( P < .01), intraoperative blood loss ( P = .04), stage ≥II ( P < .01), and R1 or R2 curability ( P < .01) were independent and significant predictors of OS. Conclusion Preoperative osteopenia was independently associated with a poor prognosis and recurrence in patients who underwent gastrectomy for GC.

Preoperative abnormal bone mineral density as a prognostic indicator in patients undergoing gastrectomy for gastric cancer: A cohort study

“…In this study, the elliptical ROI tool was used to define the ROI, ensuring it encompassed the largest circle diameter possible without including the vertebral cortex and posterior venous plexus, aligning with common practices in previous studies using elliptical ROIs. [13,14,[21][22][23][24] However, alternative approaches, including circular ROI, [12,[29][30][31][32][33][34][35] ROI with a fixed surface area, [36] and ROI in the anterior ½ to ¾ of the vertebral body [37] have been used in previous studies.…”

T‐cells infiltration mediates the association between neutrophil/lymphocyte ratio and survival in gastric cancer

“…The NLR also can reflect the cancer burden and tumor biological behavior. Kei Nakamura, et al showed that NLR was associated with undifferentiated histology, advanced clinical T stage, and N stage 24 . Kazuhiro Migita, et al concluded NLR might be associated with the extent of tumor spread at the time of recurrence 25 .…”

“…Kei Nakamura, et al showed that NLR was associated with undifferentiated histology, advanced clinical T stage, and N stage. 24 Kazuhiro Migita, et al concluded NLR might be associated with the extent of tumor spread at the time of recurrence. 25 Consistent with previous studies, we found that a high level of NLR was associated with the late tumor stage.…”

Preoperative Osteopenia as Risk Factor for Death from Other Diseases After Gastrectomy in Elderly Patients

“…Osteopenia is a recently reported prognostic factor in several digestive tract cancers, including GC (13)(14)(15)(16). Osteopenia is reportedly associated with a poor prognosis because of tumor-derived cytokines (e.g., parathyroid hormone-related protein, interleukin-1, and interleukin-6), which stimulate osteoblasts and activate the NF-kB pathway (23).…”

“…Preoperative osteopenia has recently received attention, and it was shown to be a significant prognostic factor in patients with digestive tract cancers (13)(14)(15)(16). The researchers in these previous studies measured bone mineral density (BMD) by calculating the average pixel density within a circle of the 11 th thoracic vertebra (Th11) using preoperative computed tomography (CT).…”