Perioperative risk factors for osteoporosis after radical gastrectomy for gastric cancer

Background: Osteoporosis, a frequent complication of gastrectomy, increases with age, and the average age of gastric cancer patients continues to rise. This study aims to analyze perioperative factors of osteoporosis after radical gastrectomy.

Materials and methods: This retrospective cohort study included patients who underwent dual-energy-X-ray absorptiometry after gastrectomy due to gastric cancer between 2016 and 2019 at Seoul Boramae Medical Center. Data were analyzed from before surgery to 12 months after surgery. Statistical analyses identified osteoporosis risk factors among perioperative factors.

Results: Among 189 patients, osteoporosis was diagnosed in 72 patients and peaked at 36 months postoperatively (46.3%; 24 out of 54) with the lowest mean T score of -3.34 although Ca and vitamin D supplements were prescribed to 157 patients (83.1%) on average 32.4 months postoperatively. In multivariate analysis, age (P = 0.002; Adjusted OR: 1.059, 95% CI: 1.020-1.098), body weight (P = 0.009; Adjusted OR: 0.950, 95% CI: 0.914-0.987), sex (P = 0.021; Adjusted OR: 2.322, 95% CI: 1.138-4.739), and serum ALP (P = 0.009; Adjusted OR: 1.023, 95% CI: 1.006-1.040) were significant preoperatively. Additionally, age (P = 0.005; Adjusted OR: 1.067, 95% CI: 1.020-1.116), serum Ca (P = 0.046; Adjusted OR: 0.357, 95% CI: 0.130-0.980), Cr (P = 0.003; Adjusted OR: 0.021, 95% CI: 0.002-0.268), and ALP (P = 0.014; Adjusted OR: 1.017, 95% CI: 1.003-1.030) were observed significantly at 12 months postoperatively.

Conclusions: 38.1% of patients were diagnosed with osteoporosis after radical gastrectomy, despite Ca and vitamin D supplements. Age, body weight, sex, serum Ca, Cr, and ALP correlated with osteoporosis perioperatively.