Effect of gynecological cancer and its treatment on bone mineral density and the risk of osteoporosis and osteoporotic fracture
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ObjectiveThe purpose of this study was to evaluate the risk of osteopenia and osteoporosis by examining the bone mineraldensity (BMD) of the lumbar spine and femur in patients with gynecological cancer without bone metastasis and toevaluate the impact of treatment for different cancers on BMD. MethodsThis study retrospectively reviewed the medical records of 243 women with gynecological cancer and 240 controlsbetween March 2010 and December 2016. Patients with cervical cancer (n=105), endometrial cancer (n=63), andovarian cancer (n=75) were treated with total hysterectomy including bilateral salpingo-oophorectomy and/orchemotherapy and/or radiotherapy. For the control group, healthy post-menopausal women without gynecologiccancer were selected. ResultsBefore anticancer treatment, the BMD of patients with cervical cancer and ovarian cancer was significantly lowerthan that of the controls, and the BMD of patients with endometrial cancer was not significantly different from thatof the controls. However, the BMD of endometrial cancer significantly decreased after treatment. According to thetreatment methods, there were significant differences in the BMD of L3, L4, and the femur neck. Changes in the BMDwere lowest in patients who underwent surgical treatment only, and the highest bone loss was found in patients whounderwent postoperative concurrent chemoradiotherapy. ConclusionPatients with cervical and ovarian cancer had lower BMD than those in the control group before treatment, andpatients with endometrial cancer had decreased bone density after treatment. Therefore, during the treatment ofgynecological cancer, strategies should be implemented to mitigate these risks.
Abstract
ObjectiveThe purpose of this study was to evaluate the risk of osteopenia and osteoporosis by examining the bone mineraldensity (BMD) of the lumbar spine and femur in patients with gynecological cancer without bone metastasis and toevaluate the impact of treatment for different cancers on BMD. MethodsThis study retrospectively reviewed the medical records of 243 women with gynecological cancer and 240 controlsbetween March 2010 and December 2016. Patients with cervical cancer (n=105), endometrial cancer (n=63), andovarian cancer (n=75) were treated with total hysterectomy including bilateral salpingo-oophorectomy and/orchemotherapy and/or radiotherapy. For the control group, healthy post-menopausal women without gynecologiccancer were selected. ResultsBefore anticancer treatment, the BMD of patients with cervical cancer and ovarian cancer was significantly lowerthan that of the controls, and the BMD of patients with endometrial cancer was not significantly different from thatof the controls. However, the BMD of endometrial cancer significantly decreased after treatment. According to thetreatment methods, there were significant differences in the BMD of L3, L4, and the femur neck. Changes in the BMDwere lowest in patients who underwent surgical treatment only, and the highest bone loss was found in patients whounderwent postoperative concurrent chemoradiotherapy. ConclusionPatients with cervical and ovarian cancer had lower BMD than those in the control group before treatment, andpatients with endometrial cancer had decreased bone density after treatment. Therefore, during the treatment ofgynecological cancer, strategies should be implemented to mitigate these risks.
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