Fracture after gastrectomy for gastric cancer: A long-term follow-up observational study

Publication date: February 2017
Source:European Journal of Cancer, Volume 72
Author(s): Hyun Jin Oh, Chul-Hyun Lim, Byung-Ho Yoon, Seung Bae Yoon, Myong Ki Baeg, Won Chul Kim, Yu Kyung Cho, Jae Myung Park, Myung-Gyu Choi, Han Mo Yoo, Kyo Young Song, Hae Myung Jeon, Cho Hyun Park
AimGastrectomy is a known risk factor for decreased bone mass. We aimed to evaluate the cumulative incidence and predictive factors of fracture in gastric cancer patients who underwent gastrectomy.MethodWe retrospectively reviewed the records of 1687 patients who underwent gastrectomy for gastric cancer at our hospital between September 1991 and December 2008. The exclusion criteria were stage IV gastric cancer, history of cancer recurrence, medical conditions that cause osteoporosis and high-energy injury. Fractures at sites considered to be associated with osteoporosis were diagnosed radiologically.ResultsIn total, our analysis included the records of 1131 patients. The incidence of postgastrectomy fracture was 42.1 cases per 1000 person-years. Fractures typically occurred within 3.7 ± 0.5 years postoperatively. The cumulative incidence of fracture was 9.1%, 19.7%, and 37.3% by postoperative year 2, 4, and 6, respectively. During the following years, the cumulative incidence increased slowly, up to a final 40.6%. Multivariate analysis showed that older age (hazard ratio, 1.03; 95% confidence interval, 1.01–1.04) and smoking (hazard ratio, 1.35; 95% confidence interval, 1.05–1.73) were significantly associated with fracture, whereas sex, body mass index, percent weight loss, diabetes mellitus, tumour stage, and type of gastrectomy were not.ConclusionThe cumulative incidence of fracture is high in gastric cancer patients who have undergone gastrectomy, and fracture rate is higher during the early postoperative period. Old age and smoking are independent risk factors for postgastrectomy fracture in these patients. More detailed postoperative surveillance and pharmacological intervention should be considered to prevent fracture.



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