Objective

The prognostic impact of occult vertebral fracture (OVF) in patients with malignancies is a new cutting edge in cancer research. This study was performed to analyze the prognostic impact of OVF after surgery for pancreatic cancer.

Methods

This study involved 200 patients who underwent surgical treatment of pancreatic ductal adenocarcinoma. OVF was diagnosed by quantitative measurement using preoperative sagittal computed tomography image reconstruction from the 11th thoracic vertebra to the 5th lumbar vertebra.

Results

OVF was diagnosed in 65 (32.5 %) patients. The multivariate analyses showed that male sex (p = 0.01), osteopenia (p < 0.01), OVF (p < 0.01), a carbohydrate antigen 19-9 level of ≥400 U/mL (p < 0.01), advanced stage of cancer (p < 0.01), and non-adjuvant chemotherapy (p = 0.02) were independent risk factors for overall survival. An age of ≥74 years (p < 0.01) and obstructive jaundice (p = 0.03) were independent risk factors for OVF. Furthermore, the combination of OVF and osteopenia further worsened disease-free survival and overall survival compared with osteopenia or OVF alone (p < 0.01; respectively).

Conclusion

Evaluation of preoperative OVF might be a useful prognostic indicator for patients with pancreatic ductal adenocarcinoma.

中文翻译：

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隐匿性椎体骨折对胰腺癌行胰腺切除术患者的预后意义

客观的

隐匿性椎体骨折（OVF）对恶性肿瘤患者的预后影响是癌症研究的新前沿。本研究旨在分析 OVF 对胰腺癌手术后预后的影响。

方法

这项研究涉及 200 名接受手术治疗的胰腺导管腺癌患者。OVF通过术前第11胸椎至第5腰椎矢状位计算机断层扫描图像重建进行定量测量来诊断。

结果

65 名 (32.5%) 患者被诊断为 OVF。多变量分析显示，男性（p = 0.01）、骨质减少（p < 0.01）、OVF（p < 0.01）、碳水化合物抗原19-9水平≥400 U/mL（p < 0.01）、晚期癌症(p < 0.01) 和非辅助化疗 (p = 0.02) 是总生存期的独立危险因素。年龄≥74岁（p < 0.01）和梗阻性黄疸（p = 0.03）是OVF的独立危险因素。此外，与单独使用骨质减少或 OVF 相比，OVF 和骨质减少的组合进一步恶化了无病生存率和总生存率（分别为 p < 0.01）。

结论

术前 OVF 评估可能是胰腺导管腺癌患者的一个有用的预后指标。