Obstet Gynecol Sci. 2020 Jul;63(4):470-479. doi: 10.5468/ogs.20012. Epub 2020 Jul 08.

Effect of gynecological cancer and its treatment on bone mineral density and the risk of osteoporosis and osteoporotic fracture.

Obstetrics & gynecology science

Jeong Eun Lee, Che Yon Park, Eunhyun Lee, Yong Il Ji

PMID: 32689773 PMCID: PMC7393757 DOI: 10.5468/ogs.20012

Abstract

OBJECTIVE: The purpose of this study was to evaluate the risk of osteopenia and osteoporosis by examining the bone mineral density (BMD) of the lumbar spine and femur in patients with gynecological cancer without bone metastasis and to evaluate the impact of treatment for different cancers on BMD.

METHODS: This study retrospectively reviewed the medical records of 243 women with gynecological cancer and 240 controls between March 2010 and December 2016. Patients with cervical cancer (n=105), endometrial cancer (n=63), and ovarian cancer (n=75) were treated with total hysterectomy including bilateral salpingo-oophorectomy and/or chemotherapy and/or radiotherapy. For the control group, healthy post-menopausal women without gynecologic cancer were selected.

RESULTS: Before anticancer treatment, the BMD of patients with cervical cancer and ovarian cancer was significantly lower than that of the controls, and the BMD of patients with endometrial cancer was not significantly different from that of the controls. However, the BMD of endometrial cancer significantly decreased after treatment. According to the treatment methods, there were significant differences in the BMD of L3, L4, and the femur neck. Changes in the BMD were lowest in patients who underwent surgical treatment only, and the highest bone loss was found in patients who underwent postoperative concurrent chemoradiotherapy.

CONCLUSION: Patients with cervical and ovarian cancer had lower BMD than those in the control group before treatment, and patients with endometrial cancer had decreased bone density after treatment. Therefore, during the treatment of gynecological cancer, strategies should be implemented to mitigate these risks.

Keywords: Bone density; Osteoporosis; Treatment-associated cancer

References

1. Obstet Gynecol. 1991 Oct;78(4):689-92 - PubMed
2. Int J Epidemiol. 1992 Aug;21(4):636-42 - PubMed
3. J Lipid Res. 1994 Nov;35(11):2083-93 - PubMed
4. Endocr Connect. 2012 Nov 19;2(1):11-7 - PubMed
5. J Bone Miner Res. 2000 Apr;15(4):710-20 - PubMed
6. Menopause. 2007 May-Jun;14(3 Pt 2):567-71 - PubMed
7. JAMA. 1996 Nov 6;276(17):1404-8 - PubMed
8. Jpn J Clin Oncol. 2002 Oct;32(10):422-4 - PubMed
9. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1183-8 - PubMed
10. Maturitas. 1999 Jan 4;31(2):165-70 - PubMed
11. Am J Health Syst Pharm. 2006 Mar 1;63(5):419-30 - PubMed
12. J Bone Miner Res. 1994 Aug;9(8):1137-41 - PubMed
13. Radiother Oncol. 2002 Feb;62(2):239-42 - PubMed
14. J Cancer. 2015 Jun 10;6(8):686-93 - PubMed
15. Menopause. 2010 Mar;17(2):416-20 - PubMed
16. J Clin Oncol. 2000 Apr;18(7):1570-93 - PubMed
17. Science. 1987 Aug 21;237(4817):893-6 - PubMed
18. N Engl J Med. 1997 Jul 17;337(3):199; author reply 200 - PubMed
19. J Clin Endocrinol Metab. 1995 Sep;80(9):2709-14 - PubMed
20. N Engl J Med. 1975 Dec 18;293(25):1278-83 - PubMed
21. Asia Pac J Clin Oncol. 2016 Dec;12(4):e398-e404 - PubMed
22. Lancet. 2002 Jun 1;359(9321):1929-36 - PubMed
23. J Urol. 2000 Jan;163(1):181-6 - PubMed
24. Int J Gynecol Cancer. 1994 May;4(3):161-168 - PubMed
25. J Urol. 2002 Jun;167(6):2361-7; discussion 2367 - PubMed
26. Int J Cancer. 2008 Apr 15;122(8):1879-84 - PubMed
27. N Engl J Med. 1984 Jun 28;310(26):1718-27 - PubMed
28. J Clin Invest. 1987 Dec;80(6):1803-7 - PubMed
29. Urology. 1999 Oct;54(4):607-11 - PubMed
30. Cancer Causes Control. 1994 Nov;5(6):523-8 - PubMed
31. Cancer Res. 1983 Jan;43(1):403-7 - PubMed
32. Am J Roentgenol Radium Ther Nucl Med. 1953 Sep;70(3):449-59 - PubMed
33. N Engl J Med. 1997 Feb 27;336(9):611-7 - PubMed

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