Skip to main content
Top
Published in: Archives of Osteoporosis 1/2022

Open Access 01-12-2022 | Sarcopenia | Review

Prognostic value of preoperative low bone mineral density in patients with digestive cancers: a systematic review and meta-analysis

Authors: Jun Watanabe, Akihiro Saitsu, Atsushi Miki, Kazuhiko Kotani, Naohiro Sata

Published in: Archives of Osteoporosis | Issue 1/2022

Login to get access

Abstract

Purpose

Osteopenia typically presents low bone mineral density (BMD) and has recently been reported as a prognostic factor in various cancers. However, the prognostic value of osteopenia in digestive tract cancers remains to be defined. We aimed to review the prognostic value of preoperative osteopenia in patients with digestive cancers.

Methods

Cohort studies evaluating the prognostic value of preoperative osteopenia in digestive cancers (colorectal, esophageal, hepatic, bile duct, and pancreatic cancer) were searched using electronic databases and trial registries. The exposure was defined as low BMD estimated by computed tomography at 11th thoracic vertebra, while comparator was normal BMD. The primary outcomes were overall survival and recurrence-free survival for osteopenia. Random effect meta-analyses were performed. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to assess the certainty of evidence.

Results

A total of 11 studies (2230 patients) were included. Osteopenia was an independent risk factor for overall survival (hazard ratio [HR] = 2.02, 95% CI = 1.47 to 2.78; I2 = 74%), along with sarcopenia. Osteopenia also predicted poor recurrence-free survival (HR = 1.96, 95% CI = 1.36 to 2.81; I2 = 85%). In subgroup analyses, osteopenia predicted prognosis in colorectal, esophageal, hepatic, and bile duct cancers, but not in pancreatic cancer. The certainty of the evidence was low due to inconsistency and publication bias.

Conclusion

Osteopenia may be independently associated with poor prognosis in patients with digestive tract cancer. Further studies are needed to establish the relevance of osteopenia in the operative prognosis of these patients.
Appendix
Available only for authorised users
Literature
2.
4.
go back to reference Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2 (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31. https://doi.org/10.1093/ageing/afy169CrossRefPubMed Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2 (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31. https://​doi.​org/​10.​1093/​ageing/​afy169CrossRefPubMed
6.
go back to reference Sepúlveda-Loyola W, Phu S, Bani Hassan E, Brennan-Olsen SL, Zanker J, Vogrin S, Conzade R, Kirk B, Al Saedi A, Probst V, Duque G (2020) The joint occurrence of osteoporosis and sarcopenia (osteosarcopenia): definitions and characteristics. J Am Med Dir Assoc 21:220–225. https://doi.org/10.1016/j.jamdaCrossRefPubMed Sepúlveda-Loyola W, Phu S, Bani Hassan E, Brennan-Olsen SL, Zanker J, Vogrin S, Conzade R, Kirk B, Al Saedi A, Probst V, Duque G (2020) The joint occurrence of osteoporosis and sarcopenia (osteosarcopenia): definitions and characteristics. J Am Med Dir Assoc 21:220–225. https://​doi.​org/​10.​1016/​j.​jamdaCrossRefPubMed
11.
go back to reference Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71CrossRefPubMedPubMedCentral Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://​doi.​org/​10.​1136/​bmj.​n71CrossRefPubMedPubMedCentral
12.
go back to reference Shapiro CL, Van Poznak C, Lacchetti C, Kirshner J, Eastell R, Gagel R, Smith S, Edwards BJ, Frank E, Lyman GH, Smith MR, Mhaskar R, Henderson T, Neuner J (2019) Management of osteoporosis in survivors of adult cancers with nonmetastatic disease: ASCO clinical practice guideline. J Clin Oncol 37:2916–2946. https://doi.org/10.1200/JCO.19.01696CrossRefPubMed Shapiro CL, Van Poznak C, Lacchetti C, Kirshner J, Eastell R, Gagel R, Smith S, Edwards BJ, Frank E, Lyman GH, Smith MR, Mhaskar R, Henderson T, Neuner J (2019) Management of osteoporosis in survivors of adult cancers with nonmetastatic disease: ASCO clinical practice guideline. J Clin Oncol 37:2916–2946. https://​doi.​org/​10.​1200/​JCO.​19.​01696CrossRefPubMed
19.
go back to reference Yamada D, Eguchi H, Iwagami Y, Mukai Y, Hashimoto Y, Asaoka T, Noda T, Kawamoto K, Gotoh K, Kobayashi S, Takeda Y, Tanemura M, Mori M, Doki Y (2017) Patients treated with preoperative chemoradiation for pancreatic ductal adenocarcinoma have impaired bone density, a predictor of distant metastasis. Ann Surg Oncol 24:3715–3724. https://doi.org/10.1245/s10434-017-6040-yCrossRefPubMed Yamada D, Eguchi H, Iwagami Y, Mukai Y, Hashimoto Y, Asaoka T, Noda T, Kawamoto K, Gotoh K, Kobayashi S, Takeda Y, Tanemura M, Mori M, Doki Y (2017) Patients treated with preoperative chemoradiation for pancreatic ductal adenocarcinoma have impaired bone density, a predictor of distant metastasis. Ann Surg Oncol 24:3715–3724. https://​doi.​org/​10.​1245/​s10434-017-6040-yCrossRefPubMed
20.
go back to reference Katsube T, Murayama M, Yamaguchi K, Miyaki A, Isohata N, Asaka S, Shiozawa S, Yoshimatsu K, Shimakawa T, Naritaka Y, Ogawa K (2011) Preoperative bone mineral density in gastric cancer patients. Hepatogastroenterology 58:1071–1074PubMed Katsube T, Murayama M, Yamaguchi K, Miyaki A, Isohata N, Asaka S, Shiozawa S, Yoshimatsu K, Shimakawa T, Naritaka Y, Ogawa K (2011) Preoperative bone mineral density in gastric cancer patients. Hepatogastroenterology 58:1071–1074PubMed
29.
go back to reference Furukawa K, Haruki K, Taniai T, Hamura R, Shirai Y, Yasuda J, Shiozaki H, Onda S, Gocho T, Ikegami T (2021) Osteosarcopenia is a potential predictor for the prognosis of patients who underwent hepatic resection for colorectal liver metastases. Ann Gastroenterol Surg 5:390–398CrossRefPubMedPubMedCentral Furukawa K, Haruki K, Taniai T, Hamura R, Shirai Y, Yasuda J, Shiozaki H, Onda S, Gocho T, Ikegami T (2021) Osteosarcopenia is a potential predictor for the prognosis of patients who underwent hepatic resection for colorectal liver metastases. Ann Gastroenterol Surg 5:390–398CrossRefPubMedPubMedCentral
30.
go back to reference Ikuta S, Aihara T, Nakajima T, Kasai M, Yamanaka N (2021) Computed tomography-measured bone mineral density as a surrogate marker of survival after resection of colorectal liver metastases. Ann Transl Med 9(21):10.21037/atm-20-3751 Ikuta S, Aihara T, Nakajima T, Kasai M, Yamanaka N (2021) Computed tomography-measured bone mineral density as a surrogate marker of survival after resection of colorectal liver metastases. Ann Transl Med 9(21):10.21037/atm-20-3751
33.
go back to reference Kamada T, Furukawa K, Takahashi J, Nakashima K, Nakaseko Y, Suzuki N, Yoshida M, Ohdaira H, Ikegami T, Suzuki Y (2021) Prognostic significance of osteopenia in patients with colorectal cancer: a retrospective cohort study. Ann Gastroenterol Surg 5:832–843 https://10.1002/ags3.12491CrossRefPubMedPubMedCentral Kamada T, Furukawa K, Takahashi J, Nakashima K, Nakaseko Y, Suzuki N, Yoshida M, Ohdaira H, Ikegami T, Suzuki Y (2021) Prognostic significance of osteopenia in patients with colorectal cancer: a retrospective cohort study. Ann Gastroenterol Surg 5:832–843 https://​10.​1002/​ags3.​12491CrossRefPubMedPubMedCentral
35.
go back to reference Jones DH, Nakashima T, Sanchez OH, Kozieradzki I, Komarova SV, Sarosi I, Morony S, Rubin E, Sarao R, Hojilla CV, Komnenovic V, Kong YY, Schreiber M, Dixon SJ, Sims SM, Khokha R, Wada T, Penninger JM (2006) Regulation of cancer cell migration and bone metastasis by RANKL. Nature 440:692–696. https://doi.org/10.1038/nature04524CrossRefPubMed Jones DH, Nakashima T, Sanchez OH, Kozieradzki I, Komarova SV, Sarosi I, Morony S, Rubin E, Sarao R, Hojilla CV, Komnenovic V, Kong YY, Schreiber M, Dixon SJ, Sims SM, Khokha R, Wada T, Penninger JM (2006) Regulation of cancer cell migration and bone metastasis by RANKL. Nature 440:692–696. https://​doi.​org/​10.​1038/​nature04524CrossRefPubMed
36.
go back to reference Zain NM, Seriramulu VP, Chelliah KK (2016) Bone mineral density and breast cancer risk factors among premenopausal and postmenopausal women a systematic review. Asian Pac J Cancer Prev 17:3229–3234PubMed Zain NM, Seriramulu VP, Chelliah KK (2016) Bone mineral density and breast cancer risk factors among premenopausal and postmenopausal women a systematic review. Asian Pac J Cancer Prev 17:3229–3234PubMed
39.
go back to reference Samelson EJ, Christiansen BA, Demissie S, Broe KE, Louie-Gao Q, Cupples LA, Roberts BJ, Manoharam R, D'Agostino J, Lang T, Kiel DP, Bouxsein ML (2012) QCT measures of bone strength at the thoracic and lumbar spine: the Framingham Study. J Bone Miner Res 27:654–663. https://doi.org/10.1002/jbmr.1482CrossRefPubMed Samelson EJ, Christiansen BA, Demissie S, Broe KE, Louie-Gao Q, Cupples LA, Roberts BJ, Manoharam R, D'Agostino J, Lang T, Kiel DP, Bouxsein ML (2012) QCT measures of bone strength at the thoracic and lumbar spine: the Framingham Study. J Bone Miner Res 27:654–663. https://​doi.​org/​10.​1002/​jbmr.​1482CrossRefPubMed
Metadata
Title
Prognostic value of preoperative low bone mineral density in patients with digestive cancers: a systematic review and meta-analysis
Authors
Jun Watanabe
Akihiro Saitsu
Atsushi Miki
Kazuhiko Kotani
Naohiro Sata
Publication date
01-12-2022
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-022-01060-6

Other articles of this Issue 1/2022

Archives of Osteoporosis 1/2022 Go to the issue