Bone mineral density as a prognostic marker in patients with biliary tract cancer undergoing surgery
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
Affiliations
Lisa Heinrichs
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Georg Fluegen
Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf
Sven H. Loosen
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Christina Loberg
Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Linda Wittig
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Alexander Quaas
Institute of Pathology, University Hospital Cologne and Medical Faculty, University of Cologne
Patrick S. Plum
Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital Cologne
Nils Große Hokamp
Institute for Diagnostic and Interventional Radiology, University Hospital Cologne
Peter Minko
Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Andreas Krieg
Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf
Gerald Antoch
Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Wolfram T. Knoefel
Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf
Tom Luedde
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Christoph Roderburg
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Markus S. Jördens
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf
Abstract 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.
