Metastatic bone tumors: Analysis of factors affecting prognosis and efficacy of CT and 18F-FDG PET-CT in identifying primary lesions

Shimada, Hirofumi; Setoguchi, Takao; Yokouchi, Masahiro; Sasaki, Hiromi; Ishidou, Yasuhiro; Kawamura, Ichiro; Abematsu, Masahiko; Nagano, Satoshi; Komiya, Setsuro

doi:10.3892/mco.2014.326

Cited by 15 publications

(13 citation statements)

References 18 publications

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“…Based on our data, PET scanning may be not be efficient to identify the primary sites. Other studies have similarly concluded that CT scans may be more useful than PET scans for determining the primary lesions of a bone metastasis [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Skeletal Metastasis of Unknown Primary Origin at the Initial Visit: A Retrospective Analysis of 286 Cases

et al. 2015

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BackgroundSkeletal metastasis is a common metastatic event for several carcinomas, and the treatment for skeletal metastasis of unknown primary (SMUP) are a critical issue in cancer therapy. Making a diagnosis of the primary site is the most crucial step in the treatment of SMUP; however, the procedures are sometimes difficult and time-consuming, and the primary site often remains unknown. Therefore, to establish optimal diagnostic strategies and elucidate the overall survival rates of SMUP, we conducted this retrospective study.MethodsWe retrospectively analyzed the clinical data for 286 SMUP cases from a total of 2,641 patients with skeletal metastases who were treated between 2002 and 2014 at our initiations.ResultsThe primary sites were identified in 254/286 patients (88.8%), while 32 (11.2%) primary sites were not detected by our diagnostic strategies. Lung cancer was identified in 72 (25.2%) cases, and was the most frequently observed primary lesion. The median survival time of the SMUP patients was 20.0 months, while the median survival times of solitary bone metastasis cases and multi-bone metastasis cases were 39.0 months and 16.0 months, respectively. The median survival times of prostate cancer cases was over 120 months, that of patients with primary lung cancers was 9.0 months and the median survival time of cases who were finally diagnosed with an unknown primary was 11.0 months.ConclusionsWe believe that our study would contribute to establishing an optimal strategy for diagnosing the primary site in SMUP patients, and our data provide definite indications for the survival times for different SMUP situations.

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Section: Discussionmentioning

confidence: 99%

Skeletal Metastasis of Unknown Primary Origin at the Initial Visit: A Retrospective Analysis of 286 Cases

et al. 2015

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“…A total of 6,539 cancer patients were registered in the Kagoshima University cancer registry between 2007 and 2011; 209 patients had bone metastases. In this retrospective study, we reviewed the medical records and images of 145 patients with metastatic bone tumors who were referred to the Department of Orthopaedic Surgery, Kagoshima University Hospital between 2007 and 2011 as previously reported (5). The patients included 81 men and 64 women with a mean age of 65 years (range, 29-87 years).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of prognostic scoring systems for bone metastases using single-center data

Shimada

Setoguchi

Nakamura

et al. 2015

Molecular and Clinical Oncology

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Abstract. Recent progress in cancer treatment has improved patient survival, but has increased the number of patients with metastatic bone tumors. Data were collected from all bone metastasis patients at Kagoshima University, where almost all patients with metastatic bone tumors who reside in Kagoshima province are treated surgically. The scoring systems used in bone metastasis patients were then evaluated to identify those most suitable for our patients. Clinical data were collected from 145 patients with bone metastases. The patients were assigned prognostic scores based on four scoring systems, namely those described by the Ratasvuori, Mizumoto, Tokuhashi and Katagiri groups. Statistical examinations were performed to assess patient distribution regarding prognostic factors and the four data sets reported in the literature. The patient distributions for all prognostic factors were significantly different between the Scandinavian Sarcoma Group (SSG) and Kagoshima data. The distributions of patients for 3 of 5 and for 5 of 7 prognostic factors were statistically different between the Kagoshima data and the Katagiri and Tokuhashi data, respectively. Additionally, the distribution of patients in each scoring group was statistically different between the Kagoshima data and the Katagiri, Tokuhashi and Mizumoto data. The predictions of prognosis were significantly different between the results of each group and ours. The Tokuhashi scoring system detected the highest survival at 6 months (88.8%) in the Kagoshima data. Patients with a life expectancy of >6 months benefited from tumor excision and reconstruction. These findings suggest that the Tokuhashi scoring system is the most suitable for identifying patients who should be assessed for curative surgical intervention. SSG scoring, however, was suitable for identifying patients expected to survive for <6 months (91.3%). Prior to selecting a scoring system to predict prognosis, it is important to determine which scoring system is the most appropriate, based on each hospital's particular characteristics.

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“…SREs include radiotherapy, pathological fractures, spinal cord compression, orthopedic surgery and hypercalcemia. SREs affect not only the prognosis but also the activities of daily living (6). However, to the best of our knowledge, there are currently no reports evaluating the risk factors for SREs at NSCLC diagnosis.…”

Section: Introductionmentioning

confidence: 94%

Prognostic factors in patients with skeletal-related events at non-small-cell lung cancer diagnosis

Tominaga

Setoguchi

Shimada

et al. 2017

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to detect prognostic factors in patients with skeletal-related events (SREs) and bone metastasis at the time of non-small-cell lung cancer (NSCLC) diagnosis. A total of 85 NSCLC patients were retrospectively enrolled, 47 (55.2%) of whom presented with SREs at the time of NSCLC diagnosis. Multivariate logistic regression analysis identified squamous cell carcinoma as a risk factor for SRE. Kaplan-Meier analysis demonstrated that there was no difference in the overall survival between the SRE and no SRE groups. Cox hazard model revealed that a higher Eastern Cooperative Oncology Group (ECOG) performance status (PS) score was a risk factor for poor prognosis, while surgery for bone metastasis and molecular-targeted therapy were factors for better prognosis in patients with SREs at the time of NSCLC diagnosis. Multivariate analysis revealed that a higher ECOG PS score and metastasis to the adrenal gland were risk factors for poor prognosis, while surgery for bone metastasis and molecular-targeted therapy were factors for better prognosis. Thus, while surgical treatment and molecular-targeted therapy appear to improve the prognosis of patients with bone metastasis at the time of NSCLC diagnosis, those with a higher ECOG PS score and adrenal metastasis may benefit more from radiotherapy or supportive care.

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Metastatic bone tumors: Analysis of factors affecting prognosis and efficacy of CT and 18F-FDG PET-CT in identifying primary lesions

Cited by 15 publications

References 18 publications

Skeletal Metastasis of Unknown Primary Origin at the Initial Visit: A Retrospective Analysis of 286 Cases

Skeletal Metastasis of Unknown Primary Origin at the Initial Visit: A Retrospective Analysis of 286 Cases

Evaluation of prognostic scoring systems for bone metastases using single-center data

Prognostic factors in patients with skeletal-related events at non-small-cell lung cancer diagnosis

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