Hyun Jin Oh1, Chul-Hyun Lim2, Byung-Ho Yoon3, Seung Bae Yoon1, Myong Ki Baeg1, Won Chul Kim1, Yu Kyung Cho1, Jae Myung Park1, Myung-Gyu Choi1, Han Mo Yoo4, Kyo Young Song4, Hae Myung Jeon4, Cho Hyun Park4. 1. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea. 2. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea. Electronic address: diluck@catholic.ac.kr. 3. Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Republic of Korea. 4. Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Republic of Korea.
Abstract
AIM: Gastrectomy is a known risk factor for decreased bone mass. We aimed to evaluate the cumulative incidence and predictive factors of fracture in gastric cancer patients who underwent gastrectomy. METHOD: We retrospectively reviewed the records of 1687 patients who underwent gastrectomy for gastric cancer at our hospital between September 1991 and December 2008. The exclusion criteria were stage IV gastric cancer, history of cancer recurrence, medical conditions that cause osteoporosis and high-energy injury. Fractures at sites considered to be associated with osteoporosis were diagnosed radiologically. RESULTS: In total, our analysis included the records of 1131 patients. The incidence of postgastrectomy fracture was 42.1 cases per 1000 person-years. Fractures typically occurred within 3.7 ± 0.5 years postoperatively. The cumulative incidence of fracture was 9.1%, 19.7%, and 37.3% by postoperative year 2, 4, and 6, respectively. During the following years, the cumulative incidence increased slowly, up to a final 40.6%. Multivariate analysis showed that older age (hazard ratio, 1.03; 95% confidence interval, 1.01-1.04) and smoking (hazard ratio, 1.35; 95% confidence interval, 1.05-1.73) were significantly associated with fracture, whereas sex, body mass index, percent weight loss, diabetes mellitus, tumour stage, and type of gastrectomy were not. CONCLUSION: The cumulative incidence of fracture is high in gastric cancer patients who have undergone gastrectomy, and fracture rate is higher during the early postoperative period. Old age and smoking are independent risk factors for postgastrectomy fracture in these patients. More detailed postoperative surveillance and pharmacological intervention should be considered to prevent fracture.
AIM: Gastrectomy is a known risk factor for decreased bone mass. We aimed to evaluate the cumulative incidence and predictive factors of fracture in gastric cancerpatients who underwent gastrectomy. METHOD: We retrospectively reviewed the records of 1687 patients who underwent gastrectomy for gastric cancer at our hospital between September 1991 and December 2008. The exclusion criteria were stage IV gastric cancer, history of cancer recurrence, medical conditions that cause osteoporosis and high-energy injury. Fractures at sites considered to be associated with osteoporosis were diagnosed radiologically. RESULTS: In total, our analysis included the records of 1131 patients. The incidence of postgastrectomy fracture was 42.1 cases per 1000 person-years. Fractures typically occurred within 3.7 ± 0.5 years postoperatively. The cumulative incidence of fracture was 9.1%, 19.7%, and 37.3% by postoperative year 2, 4, and 6, respectively. During the following years, the cumulative incidence increased slowly, up to a final 40.6%. Multivariate analysis showed that older age (hazard ratio, 1.03; 95% confidence interval, 1.01-1.04) and smoking (hazard ratio, 1.35; 95% confidence interval, 1.05-1.73) were significantly associated with fracture, whereas sex, body mass index, percent weight loss, diabetes mellitus, tumour stage, and type of gastrectomy were not. CONCLUSION: The cumulative incidence of fracture is high in gastric cancerpatients who have undergone gastrectomy, and fracture rate is higher during the early postoperative period. Old age and smoking are independent risk factors for postgastrectomy fracture in these patients. More detailed postoperative surveillance and pharmacological intervention should be considered to prevent fracture.
Authors: Geoffrey Roberts; Patrick R Benusiglio; Tanya Bisseling; Daniel Coit; Jeremy L Davis; Sam Grimes; Theresa A Guise; Richard Hardwick; Kirsty Harris; Paul Furman Mansfield; Jeremy Rossaak; Karen Chelcun Schreiber; Peter P Stanich; Vivian E Strong; Pardeep Kaurah Journal: Gastric Cancer Date: 2022-07-13 Impact factor: 7.701