Bone mineral density correlates with survival after resection of extrahepatic biliary malignancies
Osteopenia is a condition in which bone mineral density (BMD) is lower than normal, and it is an important determinant of bone fragility. However, the utility of osteopenia in assessing the risks of surgery is unclear. This study investigated the impact of preoperative low BMD on the outcomes in pat...
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2019-12, Vol.38 (6), p.2770-2777 |
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| creator | Yao, Siyuan Kaido, Toshimi Okumura, Shinya Iwamura, Sena Miyachi, Yosuke Shirai, Hisaya Kobayashi, Atsushi Hamaguchi, Yuhei Kamo, Naoko Uozumi, Ryuji Yagi, Shintaro Uemoto, Shinji |
| description | Osteopenia is a condition in which bone mineral density (BMD) is lower than normal, and it is an important determinant of bone fragility. However, the utility of osteopenia in assessing the risks of surgery is unclear. This study investigated the impact of preoperative low BMD on the outcomes in patients undergoing resection of extrahepatic biliary cancers.
A retrospective analysis was performed with 181 patients who underwent resections of extrahepatic biliary cancers between 2005 and 2015. Their BMD was measured on preoperative computed tomography images. Overall survival (OS) and recurrence-free survival (RFS) rates were compared according to BMD (normal vs. low), and the prognostic factors after surgery were assessed. Propensity score matching was used to minimize the bias in patient background.
Older age and female were strongly associated with low BMD. These factors were used to construct the propensity score model, which yielded a matched cohort of 52 legs in each group. The OS (21.2% vs. 53.9% at 5 years, p |
| doi_str_mv | 10.1016/j.clnu.2018.12.004 |
| format | Article |
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A retrospective analysis was performed with 181 patients who underwent resections of extrahepatic biliary cancers between 2005 and 2015. Their BMD was measured on preoperative computed tomography images. Overall survival (OS) and recurrence-free survival (RFS) rates were compared according to BMD (normal vs. low), and the prognostic factors after surgery were assessed. Propensity score matching was used to minimize the bias in patient background.
Older age and female were strongly associated with low BMD. These factors were used to construct the propensity score model, which yielded a matched cohort of 52 legs in each group. The OS (21.2% vs. 53.9% at 5 years, p < .001) and RFS (21.8% vs. 64.6% at 5 years, p < .001) rates were significantly lower in patients with low BMD (osteopenia) than in those with normal BMD (non-osteopenia). Multivariable analyses showed that low BMD was an independent factor predictive of poor OS (hazard ratio [HR]: 2.343, 95% confidence interval [CI]: 1.362–4.129, p = .002) and poor RFS (HR: 3.648, 95% CI: 1.986–6.990, p=<.001).
Preoperative low BMD is closely related to mortality and cancer recurrence after the resection of extrahepatic biliary cancers. BMD screening in patients with cancer should be further highlighted in the oncology field.
•Osteopenia represented by low bone mineral density has correlation with sarcopenia.•Older age and female are associated with low bone mineral density.•Osteopenia predicts mortality and recurrence after resection of biliary cancers.•Osteopenia screening in cancer patients should be highlighted in the oncology field.•Appropriate intervention for osteopenia prevention needs further investigation.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2018.12.004</identifier><identifier>PMID: 30595376</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Biliary cancer ; Bone mineral density ; Osteopenia ; Recurrence ; Sarcopenia ; Survival</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2019-12, Vol.38 (6), p.2770-2777</ispartof><rights>2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-248b93b6a8846a4ebb293f640441fa85c84e7d0c29e4f76725d28bd1a71867253</citedby><cites>FETCH-LOGICAL-c356t-248b93b6a8846a4ebb293f640441fa85c84e7d0c29e4f76725d28bd1a71867253</cites><orcidid>0000-0002-9546-9869 ; 0000-0002-6770-5297</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2018.12.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30595376$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yao, Siyuan</creatorcontrib><creatorcontrib>Kaido, Toshimi</creatorcontrib><creatorcontrib>Okumura, Shinya</creatorcontrib><creatorcontrib>Iwamura, Sena</creatorcontrib><creatorcontrib>Miyachi, Yosuke</creatorcontrib><creatorcontrib>Shirai, Hisaya</creatorcontrib><creatorcontrib>Kobayashi, Atsushi</creatorcontrib><creatorcontrib>Hamaguchi, Yuhei</creatorcontrib><creatorcontrib>Kamo, Naoko</creatorcontrib><creatorcontrib>Uozumi, Ryuji</creatorcontrib><creatorcontrib>Yagi, Shintaro</creatorcontrib><creatorcontrib>Uemoto, Shinji</creatorcontrib><title>Bone mineral density correlates with survival after resection of extrahepatic biliary malignancies</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>Osteopenia is a condition in which bone mineral density (BMD) is lower than normal, and it is an important determinant of bone fragility. However, the utility of osteopenia in assessing the risks of surgery is unclear. This study investigated the impact of preoperative low BMD on the outcomes in patients undergoing resection of extrahepatic biliary cancers.
A retrospective analysis was performed with 181 patients who underwent resections of extrahepatic biliary cancers between 2005 and 2015. Their BMD was measured on preoperative computed tomography images. Overall survival (OS) and recurrence-free survival (RFS) rates were compared according to BMD (normal vs. low), and the prognostic factors after surgery were assessed. Propensity score matching was used to minimize the bias in patient background.
Older age and female were strongly associated with low BMD. These factors were used to construct the propensity score model, which yielded a matched cohort of 52 legs in each group. The OS (21.2% vs. 53.9% at 5 years, p < .001) and RFS (21.8% vs. 64.6% at 5 years, p < .001) rates were significantly lower in patients with low BMD (osteopenia) than in those with normal BMD (non-osteopenia). Multivariable analyses showed that low BMD was an independent factor predictive of poor OS (hazard ratio [HR]: 2.343, 95% confidence interval [CI]: 1.362–4.129, p = .002) and poor RFS (HR: 3.648, 95% CI: 1.986–6.990, p=<.001).
Preoperative low BMD is closely related to mortality and cancer recurrence after the resection of extrahepatic biliary cancers. BMD screening in patients with cancer should be further highlighted in the oncology field.
•Osteopenia represented by low bone mineral density has correlation with sarcopenia.•Older age and female are associated with low bone mineral density.•Osteopenia predicts mortality and recurrence after resection of biliary cancers.•Osteopenia screening in cancer patients should be highlighted in the oncology field.•Appropriate intervention for osteopenia prevention needs further investigation.</description><subject>Biliary cancer</subject><subject>Bone mineral density</subject><subject>Osteopenia</subject><subject>Recurrence</subject><subject>Sarcopenia</subject><subject>Survival</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAQhi0EglL4AwzII0uC7TiOI7EA4kuqxAKz5TgXcJU4xXYK_HtctTAy3Z303Ku7B6EzSnJKqLhc5qZ3U84IlTllOSF8D81oWbCM1rLYRzPCBM1KQfkROg5hSQgpi0oeoqOClHVqxQw1N6MDPFgHXve4BRds_MZm9B56HSHgTxvfcZj82q4ToLsIHnsIYKIdHR47DF_R63dY6WgNbmxvtf_Gg-7tm9POWAgn6KDTfYDTXZ2j1_u7l9vHbPH88HR7vchMUYqYMS6bumiElpILzaFpWF10ghPOaadlaSSHqiWG1cC7SlSsbJlsWqorKjdTMUcX29yVHz8mCFENNhjoe-1gnIJiVNCa8VLUCWVb1PgxBA-dWnk7pMMVJWrjVi3Vxq3auFWUqeQ2LZ3v8qdmgPZv5VdmAq62AKQv1xa8Cul_Z6C1PvlS7Wj_y_8BtW6L_A</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Yao, Siyuan</creator><creator>Kaido, Toshimi</creator><creator>Okumura, Shinya</creator><creator>Iwamura, Sena</creator><creator>Miyachi, Yosuke</creator><creator>Shirai, Hisaya</creator><creator>Kobayashi, Atsushi</creator><creator>Hamaguchi, Yuhei</creator><creator>Kamo, Naoko</creator><creator>Uozumi, Ryuji</creator><creator>Yagi, Shintaro</creator><creator>Uemoto, Shinji</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9546-9869</orcidid><orcidid>https://orcid.org/0000-0002-6770-5297</orcidid></search><sort><creationdate>201912</creationdate><title>Bone mineral density correlates with survival after resection of extrahepatic biliary malignancies</title><author>Yao, Siyuan ; Kaido, Toshimi ; Okumura, Shinya ; Iwamura, Sena ; Miyachi, Yosuke ; Shirai, Hisaya ; Kobayashi, Atsushi ; Hamaguchi, Yuhei ; Kamo, Naoko ; Uozumi, Ryuji ; Yagi, Shintaro ; Uemoto, Shinji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-248b93b6a8846a4ebb293f640441fa85c84e7d0c29e4f76725d28bd1a71867253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Biliary cancer</topic><topic>Bone mineral density</topic><topic>Osteopenia</topic><topic>Recurrence</topic><topic>Sarcopenia</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yao, Siyuan</creatorcontrib><creatorcontrib>Kaido, Toshimi</creatorcontrib><creatorcontrib>Okumura, Shinya</creatorcontrib><creatorcontrib>Iwamura, Sena</creatorcontrib><creatorcontrib>Miyachi, Yosuke</creatorcontrib><creatorcontrib>Shirai, Hisaya</creatorcontrib><creatorcontrib>Kobayashi, Atsushi</creatorcontrib><creatorcontrib>Hamaguchi, Yuhei</creatorcontrib><creatorcontrib>Kamo, Naoko</creatorcontrib><creatorcontrib>Uozumi, Ryuji</creatorcontrib><creatorcontrib>Yagi, Shintaro</creatorcontrib><creatorcontrib>Uemoto, Shinji</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yao, Siyuan</au><au>Kaido, Toshimi</au><au>Okumura, Shinya</au><au>Iwamura, Sena</au><au>Miyachi, Yosuke</au><au>Shirai, Hisaya</au><au>Kobayashi, Atsushi</au><au>Hamaguchi, Yuhei</au><au>Kamo, Naoko</au><au>Uozumi, Ryuji</au><au>Yagi, Shintaro</au><au>Uemoto, Shinji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bone mineral density correlates with survival after resection of extrahepatic biliary malignancies</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2019-12</date><risdate>2019</risdate><volume>38</volume><issue>6</issue><spage>2770</spage><epage>2777</epage><pages>2770-2777</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><abstract>Osteopenia is a condition in which bone mineral density (BMD) is lower than normal, and it is an important determinant of bone fragility. However, the utility of osteopenia in assessing the risks of surgery is unclear. This study investigated the impact of preoperative low BMD on the outcomes in patients undergoing resection of extrahepatic biliary cancers.
A retrospective analysis was performed with 181 patients who underwent resections of extrahepatic biliary cancers between 2005 and 2015. Their BMD was measured on preoperative computed tomography images. Overall survival (OS) and recurrence-free survival (RFS) rates were compared according to BMD (normal vs. low), and the prognostic factors after surgery were assessed. Propensity score matching was used to minimize the bias in patient background.
Older age and female were strongly associated with low BMD. These factors were used to construct the propensity score model, which yielded a matched cohort of 52 legs in each group. The OS (21.2% vs. 53.9% at 5 years, p < .001) and RFS (21.8% vs. 64.6% at 5 years, p < .001) rates were significantly lower in patients with low BMD (osteopenia) than in those with normal BMD (non-osteopenia). Multivariable analyses showed that low BMD was an independent factor predictive of poor OS (hazard ratio [HR]: 2.343, 95% confidence interval [CI]: 1.362–4.129, p = .002) and poor RFS (HR: 3.648, 95% CI: 1.986–6.990, p=<.001).
Preoperative low BMD is closely related to mortality and cancer recurrence after the resection of extrahepatic biliary cancers. BMD screening in patients with cancer should be further highlighted in the oncology field.
•Osteopenia represented by low bone mineral density has correlation with sarcopenia.•Older age and female are associated with low bone mineral density.•Osteopenia predicts mortality and recurrence after resection of biliary cancers.•Osteopenia screening in cancer patients should be highlighted in the oncology field.•Appropriate intervention for osteopenia prevention needs further investigation.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30595376</pmid><doi>10.1016/j.clnu.2018.12.004</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9546-9869</orcidid><orcidid>https://orcid.org/0000-0002-6770-5297</orcidid></addata></record> |
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| subjects | Biliary cancer Bone mineral density Osteopenia Recurrence Sarcopenia Survival |
| title | Bone mineral density correlates with survival after resection of extrahepatic biliary malignancies |
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