Background: Cholangiocarcinoma (CCA) of the liver is a highly aggressive cancer that arises from malignant cells in the bile ducts. Radical surgery remains the only curative option, but major liver resection carries high perioperative risks. This study investigates the predictive value of preoperative bone mineral density (BMD), measured via CT, for perioperative complications, mortality, and long-term outcomes.Methods: The analysis included 202 patients who underwent curative-intent surgery for intrahepatic cholangiocarcinoma (iCCA; n = 97) or perihilar cholangiocarcinoma (pCCA; n = 105) between 2010 and 2019. Preoperative bone mineral density (BMD) was assessed using computed tomography segmentation at the level of the 12th thoracic vertebra. Osteopenia was defined according to established cutoffs.Results: Osteopenia was highly prevalent in both iCCA (53/97, 54%) and pCCA (54/105, 51%) subcohorts. Patients suffering from osteopenia were significantly older than those without (71.1 [62–76.6] years vs. 61.3 [52.9–69.2] years;p< 0.001). Alteration in BMD did not demonstrate a significant prognostic effect in terms of perioperative morbidity (Mann–Whitney U; comprehensive complication index—CCI: 34 [9–56] vs. 40 [21–72]p= 0.185; iCCA:p= 0.803; pCCA:p= 0.165). The median overall survival in our cohort was 19 [14–25] months. Patients with osteopenia did not exhibit a significantly different overall survival compared to those with normal bone mineral density (log-rankp= 0.234).Conclusions: In contrast to our previous observations in other oncological patient cohorts, osteopenia alone had no significant negative impact on clinical outcomes in our large European cohort of patients undergoing curative-intent surgery for CCA. To validate these findings, further prospective studies are warranted.
背景：肝内胆管癌是一种起源于胆管恶性细胞的高度侵袭性肿瘤。根治性手术仍是唯一治愈手段，但大范围肝切除伴随较高的围手术期风险。本研究旨在探讨通过CT测量的术前骨密度对围手术期并发症、死亡率及长期预后的预测价值。 方法：本研究纳入2010年至2019年间接受根治性手术的202例患者，包括肝内胆管癌（97例）和肝门部胆管癌（105例）。术前通过第12胸椎水平的计算机断层扫描分割评估骨密度，并依据既定临界值定义骨质减少。 结果：骨质减少在肝内胆管癌（53/97，54%）和肝门部胆管癌（54/105，51%）亚组中均高度普遍。骨质减少患者年龄显著高于骨密度正常者（71.1 [62–76.6]岁 vs. 61.3 [52.9–69.2]岁；p<0.001）。骨密度改变对围手术期并发症发生率未显示显著预后影响（Mann–Whitney U检验；综合并发症指数：34 [9–56] vs. 40 [21–72]，p=0.185；肝内胆管癌亚组p=0.803；肝门部胆管癌亚组p=0.165）。队列中位总生存期为19 [14–25]个月，骨质减少患者与骨密度正常者的总生存期无显著差异（时序检验p=0.234）。 结论：与我们先前在其他肿瘤患者队列中的观察结果不同，在这项接受胆管癌根治术的大型欧洲患者队列中，单纯性骨质减少并未对临床结局产生显著负面影响。为验证这些发现，有必要开展进一步前瞻性研究。
肿瘤(癌症)患者之家