Impact of the preoperative bone mineral density on the outcomes after resection of pancreatic cancer

  • Mohamed Sharshar
  • Toshimi KaidoEmail author
  • Hisaya Shirai
  • Shinya Okumura
  • Siyuan Yao
  • Yosuke Miyachi
  • Sena Iwamura
  • Naoko Kamo
  • Shintaro Yagi
  • Mahmoud Macshut
  • Shinji Uemoto
Original Article



The aim of this study is to evaluate the correlation between bone mineral density (BMD) and other body composition markers, as well as, the impact of preoperative BMD on the surgical outcomes after resection of pancreatic cancer.


This retrospective study included 275 patients who underwent surgical resection of pancreatic cancer in our institute between 2003 and 2016. Patients were divided according to BMD into low and normal groups and their postoperative outcomes were compared. Risk factors for mortality and tumor recurrence were also evaluated.


Patients with low BMD were older (P < 0.001), had a higher intramuscular adipose tissue content (P = 0.011) and higher visceral fat area (P = 0.003). The incidence of postoperative pancreatic fistula (POPF) (grade ≥ B) was higher in the low BMD group. No significant difference was observed between the two groups regarding overall survival and recurrence-free survival and low BMD was not a risk factor for mortality or tumor recurrence after resection of pancreatic cancer.


A low preoperative BMD was not found to be a risk factor for mortality or tumor recurrence after resection of pancreatic cancer; however, it was associated with a higher incidence of clinically relevant POPF.


Bone mineral density Sarcopenia Pancreatic cancer Survival Recurrence 



Body mass index


Bone mineral density

CA 19.9

Carbohydrate antigen 19.9


Computed tomography


Distal pancreatectomy


Dual-energy X-ray absorptiometry


Hazard ratio


Hepatocellular carcinoma


Hounsfield unit


Intramuscular adipose tissue content


Interquartile range


Modified Glasgow prognostic score


Neoadjuvant chemotherapy


Overall survival




Psoas muscle index


Prognostic nutritional index


Postoperative pancreatic fistula


Recurrence-free survival


Skeletal mass index


Union for International Cancer Control


Visceral to subcutaneous adipose tissue area ratio


Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest in association with the present study.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Mohamed Sharshar
    • 1
    • 2
  • Toshimi Kaido
    • 1
    • 3
    Email author
  • Hisaya Shirai
    • 1
  • Shinya Okumura
    • 1
  • Siyuan Yao
    • 1
  • Yosuke Miyachi
    • 1
  • Sena Iwamura
    • 1
  • Naoko Kamo
    • 1
  • Shintaro Yagi
    • 1
  • Mahmoud Macshut
    • 1
    • 2
  • Shinji Uemoto
    • 1
  1. 1.Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Department of Hepato-Pancreato-Biliary Surgery, National Liver InstituteMenoufia UniversityShebin ElkomEgypt
  3. 3.Department of Gastroenterology and General SurgerySt Luke’s International HospitalTokyoJapan

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