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Osteosarcopenia is a significant predictor of recurrence and the prognosis after resection for extrahepatic bile duct cancer

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Abstract

Purpose

This study examined the impact of osteosarcopenia on recurrence and the prognosis after resection for extrahepatic biliary tract cancer (EBTC).

Methods

We retrospectively analyzed 138 patients after resection for perihilar cholangiocarcinoma (11), distal cholangiocarcinoma (54), gallbladder carcinoma (30), or ampullary carcinoma (43). Osteosarcopenia is defined as the concomitant occurrence of osteopenia and sarcopenia. We investigated the relationship between osteosarcopenia and the overall survival (OS) and disease-free survival (DFS) in univariate and multivariate analyses.

Results

Osteosarcopenia was identified in 38 patients (27.5%) before propensity score (PS) matching. In the multivariate analysis, the independent recurrence factors were the prognostic nutrition index (p = 0.015), osteosarcopenia (p < 0.001), poorly differentiated adenocarcinoma (p = 0.004), perineural invasion (p = 0.002), and non-curability (p = 0.008), whereas the independent prognostic factors were prognostic nutrition index (p = 0.030), osteosarcopenia (p < 0.001), poorly differentiated adenocarcinoma (p = 0.007), lymphatic invasion (p = 0.018), and non-curability (p = 0.004). After PS matching, there was no significant difference in the variables between the patients with and without osteosarcopenia (n = 34 each). The 5-year DFS and OS after PS matching in patients with osteosarcopenia were significantly worse than in patients without osteosarcopenia (17.6% vs. 38.8%, p = 0.013 and 20.6% vs. 57.4%, p = 0.0005, respectively).

Conclusions

Preoperative osteosarcopenia could predict the DFS and OS of patients after resection for EBTC.

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Acknowledgements

We would like to thank Editage (www.editage.com) for the English language editing.

Funding

This work was supported by JSPS KAKENHI (Grant Number JP21K08805) and by research grants from the Uehara Memorial Foundation, Japanese Foundation for Multidisciplinary Treatment of Cancer, and Yakult Bio-Science Foundation.

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Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Michinori Matsumoto, Shinji Onda, Yosuke Igarashi, Ryoga Hamura, Tadashi Uwagawa, Kenei Furukawa, Yoshihiro Shirai, Takeshi Gocho, Koichiro Haruki & Toru Ikegami

Authors
  1. Michinori Matsumoto
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  2. Shinji Onda
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  3. Yosuke Igarashi
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Contributions

MM, SO, KH, and KF developed the main concepts and designed this study. MM, YI, RH, and YS were responsible for the acquisition of clinicopathological data. MM, KF, KH, TU, TG, and TI contributed to the clinical data analysis. MM, KF, KH, and TI wrote the manuscript. All authors have read and approved the manuscript for submission.

Corresponding author

Correspondence to Koichiro Haruki.

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Conflict of interest

The authors declare no conflict of interest for this article.

Approval of the research protocol

The study protocol was approved by the ethics committee of the Jikei University School of Medicine (Tokyo, Japan) (Approval No. 27-177 [8062]) and was in accordance with the provisions of the Declaration of Helsinki.

Informed consent

The need for informed consent was waived owing to the retrospective nature of the study.

Registry and registration number of the study

Not applicable.

Animal studies

Not applicable.

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Matsumoto, M., Onda, S., Igarashi, Y. et al. Osteosarcopenia is a significant predictor of recurrence and the prognosis after resection for extrahepatic bile duct cancer. Surg Today 54, 407–418 (2024). https://doi.org/10.1007/s00595-023-02747-0

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  • DOI: https://doi.org/10.1007/s00595-023-02747-0

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