Long-term changes in bone mineral density in postoperative patients with esophageal cancer.

Abstract

Aim:

The aim of this study was to investigate long-term changes in bone mineral density (BMD) after esophagectomy, identify the risk factors for postoperative osteoporosis in patients with esophageal cancer and survival outcomes related to osteoporosis.

Methods:

We retrospectively evaluated BMD changes for 197 consecutive patients with thoracic esophageal cancer who were disease-free for 5 years after radical esophagectomy. Osteoporosis was diagnosed using computed tomography with an L1 attenuation threshold of ≤110 HU. Survival analysis was performed on 381 consecutive patients with 5-year follow-up after radical esophagectomy.

Results:

BMD decreased annually after esophagectomy. The median attenuation (HU) was 134.2 before surgery and 135.2, 127.4, 123.3, 115.2, 105.6, and 102.4 at 6 months and 1, 2, 3, 4, and 5 years after surgery, respectively. Osteoporosis was diagnosed in 25.9% patients before surgery and 23.3%, 29.4%, 40.1%, 46.7%, 54.8%, and 60.4% patients with osteoporosis were observed at 6 months and 1, 2, 3, 4, and 5 years after surgery, respectively. Postoperative BMD did not decrease in patients aged ≤54 years, those who had never been smokers, and those with no weight loss after esophagectomy. Multivariate analysis identified that age (≥65 years) at surgery and smoking history were independent risk factors for osteoporosis at 5 years after esophagectomy. Patients with preoperative osteoporosis tended to have worse prognosis in disease-free survival and overall survival than those without osteoporosis, who were more likely to die due to non-esophageal cancer.

Conclusion:

Esophageal cancer survivors are more likely to develop osteoporosis after esophagectomy, and preoperative osteoporosis might be associated with prognosis.

• Authors: Takahito Sugase, Keijiro Sugimura, Takashi Kanemura, Tomohira Takeoka, Masaaki Yamamoto, Naoki Shinno, Hisashi Hara, Takeshi Omori, Masayoshi Yasui, Hiroshi Miyata
• Journal: Annals of gastroenterological surgery (Ann Gastroenterol Surg) Vol. 7 Issue 3 Pg. 419-429 (May 2023) ISSN: 2475-0328 [Electronic] Japan
• PMID: 37152773 (Publication Type: Journal Article)
• Copyright: © 2022 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.