Clinical Characteristics, Treatment Modalities, and Potential Contributing and Prognostic Factors in Patients with Bone Metastases from Gynecological Cancers: A Systematic Review

Abstract

The purpose of this study is to review the clinical characteristics, treatment modalities, and potential contributing and prognostic factors of bone metastases from gynecological cancers (GCs). A systematic literature search on PubMed, Scopus, Web of Science Core Collection and Cochrane Central Register of Controlled Trials databases was conducted. Thirty-one studies, all retrospective, were included in this review, for a total of 2880 patients with GC bone metastases. Primary tumors leading to bone metastases included endometrial cancer (EC), cervical cancer (CC), ovarian cancer (OC), uterine sarcoma (US) and vulvar cancer (VuC), mainly with an International Federation of Gynecology and Obstetrics (FIGO) Stage of III and IV. The main bone metastatic lesion site was the vertebral column, followed by the pelvic bone and lower extremity bones. The median survival rate after bone metastases diagnosis ranged from 3.0 to 45 months. The most frequent treatments were palliative and included radiotherapy and chemotherapy, followed by surgery. The findings of this review give a first dataset for a greater understanding of GC bone metastases that could help clinicians move toward a more “personalized” and thus more effective patient management.

Clinical and Pathological Profiles of Vertebral Bone Metastases from Endometrial Cancers: Evidence from a Twenty-Year Case Series

“…Despite the low reported incidence of bone metastasis from EC, autopsy series have shown a significantly higher incidence of about 35% [ 25 , 26 ], emphasizing the need of accurate clinical surveillance and screening after primary cancer. Furthermore, it was reported that the vertebral column represents the most common site of EC bone metastasis [ 7 , 8 ]. Despite these data, to date, only one case-series on six patients reported the clinicopathological characteristics, surgical outcomes, survival, and complications following surgery for vertebral bone metastases from different gynecological cancers, i.e., cervical cancer, EC, and leiomyosarcoma [ 27 ].…”

“…EC bone metastases are uncommon, and the rate is estimated to be <1% [ 6 ]. The most common site for EC bone metastasis is the vertebral column, followed by the pelvis and long bones [ 7 , 8 ]. The causes of this ”preferentially spread” have not yet been fully understood, but it has been hypothesized that the cellular and molecular characteristics of cancer cells and the tissues to which they metastasize are critical and affect the pattern of metastatic spread.…”