Detailed Abstract
[Poster Presentation 8 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP PP 8-S2] Impact of Preoperative Osteopenia on Survival Outcomes after Pancreaticoduodenectomy for Pancreatic Cancer: a Propensity-Score-Matched Analysis
Yeshong PARK 1, Jinju KIM 1, MeeYoung KANG 1, Boram LEE 1, Ho-Seong HAN 1, Yoo-Seok YOON 1
1 Department of Surgery, Seoul National University Bundang Hospital, REPUBLIC OF KOREA
Background : Osteopenia has been reported to impact survival in cancer patients; however, evidence in pancreatic cancer is scarce. This study evaluated the impact of preoperative osteopenia on survival outcomes in pancreatic cancer patients undergoing pancreaticoduodenectomy (PD).
Methods : A retrospective analysis was performed on 177 patients who underwent PD between January 2018 and December 2021 at a tertiary referral center. Preoperative bone marrow density (BMD) was measured by computed tomography with a cutoff of 135 Hounsfield units (HU) to divide patients into low and normal BMD groups.
Results : Osteopenia was associated with older age, female sex, higher body mass index, and higher American Society of Anesthesiologists score. Propensity score matching was performed to reduce bias. After matching, the low BMD group (n = 47) and normal BMD group (n = 47) were well-balanced for all clinicopathological characteristics. The low BMD group was associated with poorer five-year disease-free survival (37.6% vs. 49.6%, P = 0.012) and overall survival (39.8% vs. 79.2%, P = 0.003). In multivariable analysis, low BMD (hazard ratio (HR) 3.03, P = 0.001) and positive N stage (N1: HR 4.48, P = 0.008; N2: HR 9.59, P < 0.001) were independent risk factors for recurrence. In multivariable analysis for cancer-related survival, low BMD (HR 3.56, P = 0.002) and N2 stage (HR 3.42, P = 0.040) were prognostic factors.
Conclusions : Preoperative osteopenia is an independent predictor of recurrence and survival in pancreatic cancer patients undergoing pancreaticoduodenectomy. BMD screening and proper intervention should be regularly performed during preoperative evaluation and postoperative follow-up.
Methods : A retrospective analysis was performed on 177 patients who underwent PD between January 2018 and December 2021 at a tertiary referral center. Preoperative bone marrow density (BMD) was measured by computed tomography with a cutoff of 135 Hounsfield units (HU) to divide patients into low and normal BMD groups.
Results : Osteopenia was associated with older age, female sex, higher body mass index, and higher American Society of Anesthesiologists score. Propensity score matching was performed to reduce bias. After matching, the low BMD group (n = 47) and normal BMD group (n = 47) were well-balanced for all clinicopathological characteristics. The low BMD group was associated with poorer five-year disease-free survival (37.6% vs. 49.6%, P = 0.012) and overall survival (39.8% vs. 79.2%, P = 0.003). In multivariable analysis, low BMD (hazard ratio (HR) 3.03, P = 0.001) and positive N stage (N1: HR 4.48, P = 0.008; N2: HR 9.59, P < 0.001) were independent risk factors for recurrence. In multivariable analysis for cancer-related survival, low BMD (HR 3.56, P = 0.002) and N2 stage (HR 3.42, P = 0.040) were prognostic factors.
Conclusions : Preoperative osteopenia is an independent predictor of recurrence and survival in pancreatic cancer patients undergoing pancreaticoduodenectomy. BMD screening and proper intervention should be regularly performed during preoperative evaluation and postoperative follow-up.
SESSION
Poster Presentation 8
Zone B 3/22/2024 2:50 PM - 3:40 PM