Bone mineral density as a prognostic marker in patients with biliary tract cancer undergoing surgery

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2024年9月23日

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Lisa Heinrichs,
Georg Fluegen,
Sven H. Loosen,
Christina Loberg,
Linda Wittig,
Alexander Quaas,
Patrick S. Plum,
Nils Große Hokamp,
Peter Minko,
Andreas Krieg,
Gerald Antoch,
Wolfram T. Knoefel,
Tom Luedde,
Christoph Roderburg,
Markus S. Jördens

摘要

Background

Biliary tract cancer (BTC) is one of the most aggressive malignancies and surgery represents the only curative treatment approach. However, even in patients with complete tumor resection 5-year survival rates are below 30%. So far, prognostic markers to assess the outcome of these patients are lacking. We therefore evaluated bone mineral density (BMD) as a prognostic tool in patients receiving surgery for BTC.

methods

76 BTC patients undergoing tumor resection in our clinic (Duesseldorf cohort) as well as an external validation cohort of 34 BTC patients (Cologne cohort) were included. BMD was analyzed at the first lumbar vertebra, using routine CT scans which has been proven comparable to DXA.

Results

Median overall survival (OS) of the Duesseldorf cohort after surgery was 527 days, one- and five-year survival probabilities were 62 and 18%. Patients with BMD above 156.5 HU had significantly improved OS (1435 days vs. 459 days; p = 0.002). The prognostic value for BMD was confirmed using Cox-regression analysis, as well as an external validation cohort. In subgroup analysis the prognostic effect of BMD was only present in female patients, suggesting sex specific differences.

Conclusion

BMD is a valuable, easily accessible and independent prognostic marker in patients receiving liver surgery for BTC.