Evidence map›Paper›PMID 41460620›Full record

ArticleAnnals of surgical oncology2026

Prognostic Impact of Osteopenia in Patients with Resectable Esophageal Adenocarcinoma: A Retrospective Study.

Alberto Aiolfi, Davide Bona, Gianluca Bonitta, Quan Wang, Domenico Albano, Giulia Bonavina, Rosario Caruso, Giuseppe Banfi, Luca Maria Sconfienza, Luigi Bonavina

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Preoperative chemoradiotherapy plus pembrolizumab for esophageal squamous cell carcinoma (ACTS-29).Esophagus : official journal of the Japan Esophageal Society · 2026
    Trial
  2. Article
  3. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Alberto AiolfiDivision of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Milan, Milan, Italy. alberto.aiolfi86@gmail.com.ORCID http://orcid.org/0000-0002-7764-6075
Davide BonaDivision of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Milan, Milan, Italy.
Gianluca BonittaDivision of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Milan, Milan, Italy.
Quan WangDepartment of Biomedical Sciences for Health, Division of General and Foregut Surgery, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
Domenico AlbanoDivision of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Milan, Milan, Italy.
Giulia BonavinaDepartment of Obstetrics and Gynecology, IRCCS Multimedica, Milan, Italy.
Rosario CarusoHealth Professions Research and Development Unit, IRCCS San Donato Milanese, San Donato Milanese, Italy.
Giuseppe BanfiScientific Direction, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy.
Luca Maria SconfienzaDepartment of Biomedical Sciences for Health, University of Milan, Milan, Italy.
Luigi BonavinaDepartment of Biomedical Sciences for Health, Division of General and Foregut Surgery, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOsteopenia, marked by low bone mineral density, is a sign of patient frailty and has been linked to poor survival in patients with esophageal squamous cell carcinoma. However, its impact on overall survival (OS) and disease-free survival (DFS) in patients with esophageal adenocarcinoma is still unclear.

aimOur aim was to assess the impact of osteopenia on long-term survival in patients with resectable esophageal adenocarcinoma.

methodsThis was a retrospective study (January 2014-December 2024) including patients with resectable Siewert I-II esophageal adenocarcinoma who underwent Ivor-Lewis esophagectomy. Osteopenia was defined as reduced bone mineral density (<160 Hounsfield units) measured at the level of the first lumbar vertebra on preoperative computed tomography scan.

resultsOverall, 338 patients were included. The prevalence of osteopenia was 27.8%. Anastomotic leak (22.3% vs. 11.9%; p=0.04), pneumonia (17.1% vs. 6.9%; p=0.01), and 90-day mortality (8.5% vs. 2.1%; p=0.02) were higher in patients with osteopenia. On multivariate analysis, osteopenia was an independent predictor of pneumonia (hazard ratio [HR] 1.42; 95% confidence interval [CI] 1.06-1.86) and 90-day mortality (HR 1.35; 95% CI 1.12-1.95) but not anastomotic leak (HR 1.51; 95% CI 0.91-1.76). Patients with osteopenia had significantly lower 60-month OS probability (49.9% vs. 70.5%; p<0.001) and DFS probability (45.7% vs. 61.5%; p=0.002). Osteopenia independently predicted poorer OS (HR 2.03; 95% CI 1.54-2.95) and DFS (HR 1.51; 95% CI 1.12-2.35).

conclusionsOsteopenia may affect up to one-third of patients with esophageal adenocarcinoma. Osteopenia was independently associated with postoperative pneumonia and 90-day mortality and poor long-term survival. Patients with osteopenia have lower OS and DFS than those without osteopenia.

Indexed as

AdenocarcinomaBone Diseases, MetabolicEsophageal NeoplasmsEsophagectomyAgedBone DensityFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateBone mineral densityComplicationsDisease-free survivalEsophageal cancerOverall survival

Identifiers

PMID41460620

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.