Bone loss, osteoporosis, and fractures in patients with resected pancreatic head cancer.

[BACKGROUND] Major pancreatic resections are considered to have a high risk of developing osteoporosis. This study aimed to examine factors associated with bone mineral density (BMD) loss, osteoporosis, and fractures among pancreatic head cancer patients who underwent resection.

[METHODS] We retrospectively investigated consecutive pancreatic head cancer patients who underwent resection and had evaluable computed tomography (CT) before surgery and at one-year follow-up. BMD was measured using CT images at the L1 vertebra. Osteoporosis was defined as BMD <135 Hounsfield units. The prevalence and risk factors for BMD loss, osteoporosis, and fractures were examined.

[RESULTS] A total of 364 patients were included. Osteoporosis was associated with older age, higher rate of severe complications, and lower rate of receiving adjuvant chemotherapy. BMD consistently decreased over time regardless of age, sex, or cancer stage, leading to accelerating increase in the prevalence of osteoporosis over time (50.8 % at baseline and 73.1 % at one year). BMD loss was greater in young patients, males, patients with late-stage cancer, and patients who developed postoperative recurrence. Incident fractures developed in 47 patients (12.9 %) during follow-up, which were associated with older age, osteoporosis at the time of surgery, and postoperative recurrence.

[CONCLUSIONS] Pancreatic head cancer patients who underwent resection showed an increased risk of BMD loss, osteoporosis and fractures. Screening for osteoporosis should be considered in pancreatic head cancer patients who underwent resection.