Management of Lung Cancer Presenting with Solitary Bone Metastasis

Nistor, Claudiu; Ciuche, Adrian; Cucu, Anca-Pati; Nițipir, Cornelia; Slavu, Cristina; Șerban, Bogdan; Cursaru, Adrian; Creţu, Bogdan; Cîrstoiu, Cătălin

doi:10.3390/medicina58101463

Cited by 17 publications

(13 citation statements)

References 41 publications

(42 reference statements)

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“…Previous studies estimate the incidence of BM in lung cancer to be approximately 10%-15% [10]. Patients experiencing BM witness a significant reduction in quality of life and a median survival time ranging from 6 to 10 months, with a one-year survival rate posttreatment around 40% to 50% [11]. Skeletalrelated events afflict 46% of patients with BM, significantly shortening their survival time [12].…”

Section: Discussionmentioning

confidence: 99%

Predictive nomogram for bone metastases in lung cancer based on monocyte infiltration

2024

Am J Cancer Res

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The presence of bone metastases (BM) in patients with lung cancer is indicative of a worse prognosis. The present study aims to investigate the risk factors associated with BM in patients with lung cancer. Patients with lung cancer admitted to the First Affiliated Hospital of Anhui Medical University between June 2019 and September 2021 were enrolled in this study. A nomogram was constructed based on the outcomes derived from univariate and multivariate analyses. Concordance index, calibration plots, receiver operating characteristic curves, and decision curve analysis were used to evaluate the nomogram. To substantiate the influence of monocytes on lung cancer BM, various assays, including cell co-culture, Transwell, wound-healing assays, and immunohistochemistry and immunofluorescence staining, were conducted. Statistical analyses were performed using SPSS 22.0 software and GraphPad Prism 7.0. A total of 462 eligible patients were enrolled, comprising 220 with BM and 242 without. Multivariate analysis revealed that histological type, medical history, monocyte percentage, and LDH (Lactate Dehydrogenase) and ALP (Alkaline Phosphatase) levels were independent risk factors for BM in lung cancer. Transwell and woundhealing assays indicated that co-culture with monocytes significantly enhanced the migration and invasion capabilities of A549 cells in vitro. Immunohistochemistry and immunofluorescence analyses demonstrated a noteworthy increase in monocyte infiltration in the primary lesions of patients with lung cancer with BM. In conclusion, this study successfully constructed and validated a precise, straightforward, and cost-effective prognostic nomogram for patients with lung cancer with BM.

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Section: Discussionmentioning

confidence: 99%

Predictive nomogram for bone metastases in lung cancer based on monocyte infiltration

2024

Am J Cancer Res

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“…While the modern era is marked by an aging population [30], both osteoporosis and T2DM might come as mandatory issues to be addressed from all multidisciplinary perspectives, from primary to tertiary care, from medical to social approaches [31][32][33][34][35][36][37][38][39]. Noting these important mentioned aspects, the assessment of bone fragility among T2DM comes as urgent.…”

Section: The Scientific Background Of Why the Study Topic Must Be Con...mentioning

confidence: 99%

Trabecular Bone Score (TBS) in Individuals with Type 2 Diabetes Mellitus: An Updated Review

Trandafir,

Sima,

Gheorghe

et al. 2023

JCM

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Bone fragility is a complication of type 2 diabetes mellitus (T2DM) that has been identified in recent decades. Trabecular bone score (TBS) appears to be more accurate than bone mineral density (BMD) in diabetic bone disease, particularly in menopausal women with T2DM, to independently capture the fracture risk. Our purpose was to provide the most recent overview on TBS-associated clinical data in T2DM. The core of this narrative review is based on original studies (PubMed-indexed journals, full-length, English articles). The sample-based analysis (n = 11, N = 4653) confirmed the use of TBS in T2DM particularly in females (females/males ratio of 1.9), with ages varying between 35 and 91 (mean 65.34) years. With concern to the study design, apart from the transversal studies, two others were prospective, while another two were case-control. These early-post-pandemic data included studies of various sample sizes, such as: males and females (N of 245, 361, 511, and 2294), only women (N of 80, 96, 104, 243, 493, and 887), and only men (N = 169). Overall, this 21-month study on published data confirmed the prior profile of BMD-TBS in T2DM, while the issue of whether checking the fracture risk is mandatory in adults with uncontrolled T2DM remains to be proven or whether, on the other hand, a reduced TBS might function as a surrogate marker of complicated/uncontrolled T2DM. The interventional approach with bisphosphonates for treating T2DM-associated osteoporosis remains a standard one (n = 2). One control study on 4 mg zoledronic acid showed after 1 year a statistically significant increase of lumbar BMD in both diabetic and non-diabetic groups (+3.6%, p = 0.01 and +6.2%, p = 0.01, respectively). Further studies will pinpoint additive benefits on glucose status of anti-osteoporotic drugs or will confirm if certain glucose-lowering regimes are supplementarily beneficial for fracture risk reduction. The novelty of this literature research: these insights showed once again that the patients with T2DM often have a lower TBS than those without diabetes or with normal glucose levels. Therefore, the decline in TBS may reflect an early stage of bone health impairment in T2DM. The novelty of the TBS as a handy, non-invasive method that proved to be an index of bone microarchitecture confirms its practicality as an easily applicable tool for assessing bone fragility in T2DM.

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“…Distant metastasis often occurs when lung cancer progresses in the course of the disease, and common sites of metastasis include intracranial, bone, lymph nodes, and so on ( 5 ). Among them, bones, especially load-bearing bones such as the middle shaft bone, are common remote metastatic sites of lung cancer ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the predictive significance of systemic immune-inflammatory index and tumor markers in lung cancer patients with bone metastases

He,

Liang,

et al. 2024

Front. Oncol.

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ObjectiveThis study aims to develop a predictive model for identifying lung cancer patients at elevated risk for bone metastases, utilizing the Unified Immunoinflammatory Index and various tumor markers. This model is expected to facilitate timely and effective therapeutic interventions, especially in the context of the growing significance of immunotherapy for lung cancer treatment.MethodsA retrospective analysis was conducted on 324 lung cancer patients treated between January 2019 and January 2021. After meeting the inclusion criteria, 241 patients were selected, with 56 exhibiting bone metastases. The cohort was divided into a training group (169 patients) and a validation group (72 patients) at a 7:3 ratio. Lasso regression was employed to identify critical variables, followed by logistic regression to construct a Nomogram model for predicting bone metastases. The model’s validity was ascertained through internal and external evaluations using the Concordance Index (C-index) and Receiver Operating Characteristic (ROC) curve.ResultsThe study identified several factors influencing bone metastasis in lung cancer, such as the Systemic Immune-Inflammatory Index (SII), Carcinoembryonic Antigen (CEA), Neuron Specific Enolase (NSE), Cyfra21-1, and Neutrophil-to-Lymphocyte Ratio (NLR). These factors were incorporated into the Nomogram model, demonstrating high validation accuracy with C-index scores of 0.936 for internal and 0.924 for external validation.ConclusionThe research successfully developed an intuitive and accurate Nomogram prediction model utilizing clinical indicators to predict the risk of bone metastases in lung cancer patients. This tool can be instrumental in aiding clinicians in developing personalized treatment plans, thereby optimizing patient outcomes in lung cancer care.

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Management of Lung Cancer Presenting with Solitary Bone Metastasis

Cited by 17 publications

References 41 publications

Predictive nomogram for bone metastases in lung cancer based on monocyte infiltration

Predictive nomogram for bone metastases in lung cancer based on monocyte infiltration

Trabecular Bone Score (TBS) in Individuals with Type 2 Diabetes Mellitus: An Updated Review

Evaluating the predictive significance of systemic immune-inflammatory index and tumor markers in lung cancer patients with bone metastases

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