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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

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Bone mineral density Sarcopenia Pancreatic cancer Survival Recurrence 

Abbreviations

BMI

Body mass index

BMD

Bone mineral density

CA 19.9

Carbohydrate antigen 19.9

CT

Computed tomography

DP

Distal pancreatectomy

DXA

Dual-energy X-ray absorptiometry

HR

Hazard ratio

HCC

Hepatocellular carcinoma

HU

Hounsfield unit

IMAC

Intramuscular adipose tissue content

IQR

Interquartile range

mGPS

Modified Glasgow prognostic score

NAC

Neoadjuvant chemotherapy

OS

Overall survival

PD

Pancreaticodudonectomy

PMI

Psoas muscle index

PNI

Prognostic nutritional index

POPF

Postoperative pancreatic fistula

RFS

Recurrence-free survival

SMI

Skeletal mass index

UICC

Union for International Cancer Control

VSR

Visceral to subcutaneous adipose tissue area ratio

Notes

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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