Prognostic Impact of Preoperative Osteosarcopenia for Patients with Pancreatic Ductal Adenocarcinoma After Curative Resection

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2023 Jul 19

PMID 37466870

Authors

Toshiya Abe

Kohei Nakata

So Nakamura

Noboru Ideno

Naoki Ikenaga

Nobuhiro Fujita

Kousei Ishigami

Kazuyoshi Nishihara

Masafumi Nakamura

Affiliations

Soon will be listed here.

Abstract

Backgrounds: The clinical significance of preoperative osteosarcopenia in pancreatic ductal adenocarcinoma (PDAC) has not been fully studied. The purpose of this study was to evaluate the role of preoperative osteosarcopenia in predicting the survival of patients with PDAC.

Methods: We retrospectively analyzed 265 patients who underwent curative surgical resection for PDAC between 2012 and 2018 in two Japanese institutes. The skeletal muscle index at the L3 vertebrae and the bone mineral density at the Th11 vertebra were calculated for the evaluation of osteosarcopenia before surgery. The relationship between perioperative osteosarcopenia and clinicopathological factors and prognosis was analyzed.

Results: The median overall survival (OS) and disease-free survival (DFS) of patients with osteosarcopenia were significantly shorter than those of patients without osteosarcopenia (OS: 23 and 48 months, respectively, P < 0.001; DFS: 13.4 and 21.2 months, respectively, P = 0.004). On multivariate analysis, osteosarcopenia was found to be an independent factor associated with OS (hazard ratio [HR] 1.98; 95% confidence interval [CI] 1.40-2.80; P < 0.001) and DFS (HR 1.53; 95% CI 1.11-2.10; P = 0.009).

Conclusions: Preoperative osteosarcopenia may be a useful prognostic factor in patients with PDAC who undergo surgical resection. Further studies are needed to assess whether perioperative, nutritional interventions and rehabilitation contribute to improving the prognosis of these patients.

Citing Articles

Prognostic significance of osteosarcopenia in patients with stage IV gastric cancer undergoing conversion surgery.

Hirase Y, Arigami T, Matsushita D, Shimonosono M, Tsuruda Y, Sasaki K Langenbecks Arch Surg. 2024; 410(1):7.

PMID: 39673019 PMC: 11645300. DOI: 10.1007/s00423-024-03574-8.

Prognostic impact of preoperative osteosarcopenia on esophageal cancer surgery outcomes: a retrospective analysis.

Hirase Y, Sasaki K, Tsuruda Y, Shimonosono M, Uchikado Y, Matsushita D Esophagus. 2024; 22(1):77-84.

PMID: 39604759 DOI: 10.1007/s10388-024-01101-8.

Osteosarcopenia in patients with cancer: A systematic review and meta-analysis.

Wang C, Liu H, Lin W, Wu L, Guo H, Huang S Medicine (Baltimore). 2024; 103(45):e40476.

PMID: 39533564 PMC: 11557054. DOI: 10.1097/MD.0000000000040476.

Impact of osteopenia and osteosarcopenia on the outcomes after surgery of hepatobiliary-pancreatic cancers.

Wang X, Wu M, Liu Q, He W, Tian Y, Zhang Y Front Oncol. 2024; 14:1403822.

PMID: 39099698 PMC: 11294096. DOI: 10.3389/fonc.2024.1403822.

Osteosarcopenia: the coexistence of sarcopenia and osteopenia is predictive of prognosis and postoperative complications after curative resection for colorectal cancer.

Fujimoto T, Tamura K, Nagayoshi K, Mizuuchi Y, Oh Y, Nara T Surg Today. 2024; 55(1):78-89.

PMID: 38880803 DOI: 10.1007/s00595-024-02883-1.

References

Siegel R, Miller K, Wagle N, Jemal A . Cancer statistics, 2023. CA Cancer J Clin. 2023; 73(1):17-48. DOI: 10.3322/caac.21763. View

Conlon K, Klimstra D, Brennan M . Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors. Ann Surg. 1996; 223(3):273-9. PMC: 1235115. DOI: 10.1097/00000658-199603000-00007. View

Abe T, Nakata K, Kibe S, Mori Y, Miyasaka Y, Ohuchida K . Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol. 2018; 25(13):3996-4003. DOI: 10.1245/s10434-018-6761-6. View

Peng P, Hyder O, Firoozmand A, Kneuertz P, Schulick R, Huang D . Impact of sarcopenia on outcomes following resection of pancreatic adenocarcinoma. J Gastrointest Surg. 2012; 16(8):1478-86. PMC: 3578313. DOI: 10.1007/s11605-012-1923-5. View

Abe K, Furukawa K, Okamoto T, Matsumoto M, Futagawa Y, Haruki K . Impact of osteopenia on surgical and oncological outcomes in patients with pancreatic cancer. Int J Clin Oncol. 2021; 26(10):1929-1937. DOI: 10.1007/s10147-021-01986-w. View

Kirk B, Zanker J, Duque G . Osteosarcopenia: epidemiology, diagnosis, and treatment-facts and numbers. J Cachexia Sarcopenia Muscle. 2020; 11(3):609-618. PMC: 7296259. DOI: 10.1002/jcsm.12567. View

Furukawa K, Haruki K, Taniai T, Hamura R, Shirai Y, Yasuda J . Osteosarcopenia is a potential predictor for the prognosis of patients who underwent hepatic resection for colorectal liver metastases. Ann Gastroenterol Surg. 2021; 5(3):390-398. PMC: 8164456. DOI: 10.1002/ags3.12428. View

Taniai T, Haruki K, Yanagaki M, Igarashi Y, Furukawa K, Onda S . Osteosarcopenia predicts poor prognosis for patients with intrahepatic cholangiocarcinoma after hepatic resection. Surg Today. 2022; 53(1):82-89. DOI: 10.1007/s00595-022-02550-3. View

Yanagaki M, Haruki K, Taniai T, Igarashi Y, Yasuda J, Furukawa K . The significance of osteosarcopenia as a predictor of the long-term outcomes in hepatocellular carcinoma after hepatic resection. J Hepatobiliary Pancreat Sci. 2022; 30(4):453-461. DOI: 10.1002/jhbp.1246. View

10.

Clavien P, Barkun J, De Oliveira M, Vauthey J, Dindo D, Schulick R . The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009; 250(2):187-96. DOI: 10.1097/SLA.0b013e3181b13ca2. View

11.

Okumura S, Kaido T, Hamaguchi Y, Fujimoto Y, Masui T, Mizumoto M . Impact of preoperative quality as well as quantity of skeletal muscle on survival after resection of pancreatic cancer. Surgery. 2015; 157(6):1088-98. DOI: 10.1016/j.surg.2015.02.002. View

12.

Okumura S, Kaido T, Hamaguchi Y, Kobayashi A, Shirai H, Yao S . Visceral Adiposity and Sarcopenic Visceral Obesity are Associated with Poor Prognosis After Resection of Pancreatic Cancer. Ann Surg Oncol. 2017; 24(12):3732-3740. DOI: 10.1245/s10434-017-6077-y. View

13.

Motomura T, Uchiyama H, Iguchi T, Ninomiya M, Yoshida R, Honboh T . Impact of Osteopenia on Oncologic Outcomes After Curative Resection for Pancreatic Cancer. In Vivo. 2020; 34(6):3551-3557. PMC: 7811648. DOI: 10.21873/invivo.12198. View

14.

McMillan D, Crozier J, Canna K, Angerson W, McArdle C . Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis. 2007; 22(8):881-6. DOI: 10.1007/s00384-006-0259-6. View

15.

Onodera T, Goseki N, KOSAKI G . [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi. 1984; 85(9):1001-5. View

16.

Okada K, Kouda K, Kawai M, Hirono S, Miyazawa M, Kitahata Y . Supervised Exercise Therapy and Adjuvant Chemotherapy for Pancreatic Cancer: A Prospective, Single-Arm, Phase II Open-Label, Nonrandomized, Historically Controlled Study. J Am Coll Surg. 2022; 235(6):848-858. DOI: 10.1097/XCS.0000000000000408. View

17.

Kemmler W, Kohl M, Frohlich M, Jakob F, Engelke K, von Stengel S . Effects of High-Intensity Resistance Training on Osteopenia and Sarcopenia Parameters in Older Men with Osteosarcopenia-One-Year Results of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST). J Bone Miner Res. 2020; 35(9):1634-1644. DOI: 10.1002/jbmr.4027. View