Bone Mineral Density as a Risk Factor for Patients Undergoing Surgery for Hepatocellular Carcinoma
Yosuke Miyachi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorCorresponding Author
Toshimi Kaido
- [email protected]
- +81-75-751-3243
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Tel.: +81-75-751-3243, [email protected]Search for more papers by this authorSiuan Yao
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorHisaya Shirai
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorAtsushi Kobayashi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorYuhei Hamaguchi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorNaoko Kamo
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorShintaro Yagi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorShinji Uemoto
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorYosuke Miyachi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorCorresponding Author
Toshimi Kaido
- [email protected]
- +81-75-751-3243
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Tel.: +81-75-751-3243, [email protected]Search for more papers by this authorSiuan Yao
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorHisaya Shirai
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorAtsushi Kobayashi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorYuhei Hamaguchi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorNaoko Kamo
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorShintaro Yagi
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorShinji Uemoto
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507 Kyoto, Japan
Search for more papers by this authorAbstract
Background
We have reported the impact of sarcopenia and body composition on patients undergoing hepatectomy for hepatocellular carcinoma (HCC). However, the impact of bone mineral density (BMD) on outcomes after hepatectomy for HCC and correlation with other parameters including sarcopenia are unclear.
Methods
We retrospectively analyzed 465 patients who underwent primary hepatectomy for HCC between April 2005 and March 2015. We analyzed the plain CT images at the level of the eleventh thoracic vertebra with the region of interest and defined as preoperative BMD.
Results
In this cohort, male (n = 367) and female (n = 98) patients showed significant heterogeneity in age, body composition markers, tumor factors, peri-operative parameters and so on. The median preoperative BMD in male and female patients was 155 and 139 HU, respectively (P = 0.005). BMD was negatively correlated with age in female (r = −0.590, P < 0.001) and intramuscular adipose tissue content in both male and female (r = −0.332 and −0.359, respectively, P < 0.001). For males, BMD < 160 HU was associated with worse cancer-specific survival post-hepatectomy (P = 0.015). In contrast, females were not (P = 0.135). For male patients, multivariate analysis identified low BMD as an independent risk factor for death (hazard ratio 1.720, 95% confidence interval 1.038–2.922, P = 0.035) after hepatectomy for HCC.
Conclusion
Preoperative low BMD was an independent risk factor for cancer-specific mortality after hepatectomy for HCC.
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