The following is a summary of “Prognostic Impact of Preoperative Osteopenia in Patients With Colorectal Cancer,” published in the December 2023 issue of Gastroenterology by Kato, et al.
Osteopenia, a disease in which bone mineral density is lower than usual, is known to lower the life expectancy of people with it. For a study, researchers sought to look into how osteopenia before surgery affects the prognosis of people with colon cancer. A total of 1,086 people with colon cancer in stages I to III had successful surgery. CT was used to check for osteopenia. The main endpoints were overall survival, disease-specific survival, and recurrence-free survival. Osteopenia was found in 300 cases, or 27.6%.
The total survival rate over 5 years was much lower in the osteopenia group (74.0% vs. 93.4%, P < 0.001), as were the disease-specific survival rates (81.6% vs 97.2%, P < 0.001) and the recurrence-free survival rates (57.1% vs 88.3%, P < 0.001). There was a strong link between osteopenia before surgery and worse overall survival (HR: 4.135; 95% CI, 2.963–5.770; P < 0.001), disease-specific survival (HR: 7.673; 95% CI, 4.646–12.675; P < 0.001), and recurrence-free survival (HR: 5.039; 95% CI, 3.811–6.662; P < 0.001).
At every stage, the outlook for the people with osteopenia was worse than for those without it: Overall survival at 5 years was 89.4% vs 96.9%, P = 0.028; recurrence-free survival at 5 years was 85.4% vs 96.6%, P = 0.002; recurrence-free survival at 5 years was 62.0% vs. 86.5%, P < 0.001; and recurrence-free survival at 5 years was 26.4% vs. 80.0%, P < 0.001. The main problems were the study’s retrospective nature and the fact that the people in the study were of different races. Osteopenia before surgery could be a good indicator of how colon cancer will do in the long run, no matter what stage it is in.
