Natural history of skeletal-related events in patients with breast, lung, or prostate cancer and metastases to bone: a 15-year study in two large US health systems

Oster, Gerry; Lamerato, Lois; Glass, Andrew G.; Richert-Boe, Kathryn; Lopez, A.; Chung, Karen; Richhariya, Akshara; Dodge, Tracy; Wolff, G; Balakumaran, Arun; Edelsberg, John

doi:10.1007/s00520-013-1887-3

Cited by 147 publications

(114 citation statements)

References 25 publications

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“…These findings are similar to those of a previous Japanese study [3]. Although the incidence of SREs in patients with PCa in the present study was low compared to that observed in a previous large multicenter study [1, 4] (38–51.7%), the incidence of SREs in patients with RCC was similar to that found in a previous study [5] (72%). It is not clear why the incidence of SREs in patients with PCa was lower in a Japanese cohort than the incidence observed in European or American countries.…”

Section: Discussionsupporting

confidence: 77%

“…SREs include pathological fractures, spinal cord compression, need for bone palliative radiotherapy/surgical intervention, and hypercalcemia. The incidence of SREs in prostate cancer (PCa), renal cell carcinoma (RCC), and urothelial carcinoma (UC) with bone metastasis is high, with previous publications reporting rates of 29–51.7% [1-4], 72–82% [3, 5], and 65–68% [3, 6], respectively. However, there have been few studies comparing clinical information and risk factors related to SREs in GU cancers with bone metastasis.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features and Risk Factors of Skeletal-Related Events in Genitourinary Cancer Patients with Bone Metastasis: A Retrospective Analysis of Prostate Cancer, Renal Cell Carcinoma, and Urothelial Carcinoma

et al. 2018

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Objective: The objective of the present study was to report the incidence of skeletal-related events (SREs) and identify risk factors for SREs in patients with genitourinary cancer with newly diagnosed bone metastasis. Methods: This retrospective study included 180 patients with bone metastasis from prostate cancer (PCa; n = 111), renal cell carcinoma (RCC; n = 43), and urothelial carcinoma (UC; n = 26). Clinical factors at the time of diagnosis of bone metastasis were evaluated with Cox proportional hazards regression analysis to identify independent risk factors for SREs. Results: During follow-up, 29 (26%) patients with PCa, 30 (70%) with RCC, and 15 (58%) with UC developed SREs. Treatment with bone-modifying agents (BMAs) before the development of SREs and within 6 months from the diagnosis of bone metastasis significantly delayed the time to first SRE as compared to nonuse of BMAs. Multivariate analysis identified type of primary cancer (PCa vs. RCC, PCa vs. UC), performance status, and bone pain as significant independent predictive risk factors for SREs. Conclusions: Treatment with BMAs significantly delayed the development of first SREs. The identified predictors of SREs might be useful to select patients who would benefit most from early treatment with BMAs.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Clinical Features and Risk Factors of Skeletal-Related Events in Genitourinary Cancer Patients with Bone Metastasis: A Retrospective Analysis of Prostate Cancer, Renal Cell Carcinoma, and Urothelial Carcinoma

et al. 2018

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“…Oster és mtsai [20] 723 prostatacarcinomás betegének egyéves átlag-túlélése 73% volt, míg ugyanez az érték Weiss és mtsai [21] beteganyagában (306 beteg), ahol már műtétet indokló csontáttétek jelentek meg, már 29%-ra csökkent. Szintén csökkenti a túlélést, ha a csontáttétes beteg 70 év feletti, nagyszámú csont-, illetve visceralis áttéttel rendelkezik, magas a szérum-alkalikusfoszfatáz értéke és ha az androgének megvonására igen magas PSA-értékek alakulnak ki [22].…”

Section: Prognosztikai Faktorok éS Diagnosztikai Algoritmus Jelentőséunclassified

“…Szelektálatlan, azaz mindenfajta tumor csontmetasztázi-sát magába foglaló közlemények egyéves túlélése 39-54% között mozgott [2,8,[25][26][27], ami alacsonyabbnak bizonyult az emlő-vagy veseráknál észlelteknél [11, 12, 14, 18-20, 28, 29], de nem meglepő módon lényegesen meghaladta a tüdőrákok egyéves túlélési eredményeit [20,30,31]. Az emlő-és veserákok 45-58%-os egyéves biztató túlélési eredményei azonban az első öt év végére már mindössze 8-20%-ra csökkentek [11,14,19,28].…”

Section: Prognosztikai Faktorok éS Diagnosztikai Algoritmus Jelentőséunclassified

Paradigmaváltás a csontmetasztázisok sebészetében. I. Végtagi és medencelokalizációjú áttétek

et al. 2017

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Rákregiszterek statisztikái szerint míg a rák incidenciája az elmúlt évtizedben is folyamatosan nőtt, az újabb hatásos multimodalitású kezelések eredményeképpen a mortalitása alig emelkedett. Összefoglaló közleményünk célja annak bemutatása, hogy újabb irodalmi adatok alapján hogyan változott a csontmetasztázisos betegek túlélése, milyen prognosztikai faktorok befolyásolják a betegek esélyeit. A jobb eredmények aktívabb sebészi beavatkozást eredményeztek a végtagi és a csigolyaáttétek kezelésében egyaránt. Bemutatjuk a sebészi rekonstrukciós eljárások algoritmusát, tár-gyaljuk a különböző megoldások előnyeit, hátrányait, szövődményeit. Megállapítható, hogy a patológiás/fenyegető patológiás törésektől eltekintve nem a sebészi az első körben választandó eljárás, és ez is rendszerint palliatív céllal történik. Célja, hogy a beteg fájdalmait csökkentsük, mobilitását visszaadjuk, életminőségét javítsuk, lehetőleg olyan kevéssé megterhelő eljárásokkal (minimálisan invazív), amelyek gyors rehabilitációt tesznek lehetővé, és a beteg élete végéig kitartanak. Optimális esetben, körülbelül 10-15%-ban, lehetőség van a metasztázis kuratív eltávolítására is, biztatóak a jobb túlélési eredmények. Orv Hetil. 2017; 158(40): 1563-1569.Kulcsszavak: csontmetasztázis, kivizsgálási algoritmus, prognosztikai faktorok, végtag, medence, metasztázis-sebészet Change of paradigm in the surgical treatment of metastatic diseases of bone Part I. Bony metastases of the extremities and pelvisAccording to the statistical data of tumor registries the incidence of cancer has increased in the last decade, however the mortality shows only a slight change due to the new and effective multimodal treatments. The aim of our overview article is to present the changes in the survival of the metastatic patients, and to demonstrate which factors influence their prognosis. The improvement of survival resulted in a more active surgical role both in metastases of the bone of the extremities and the pelvis. We present a diagnostic flow chart and current options for the reconstruction of the different regions of the bone and skeleton, and we will discuss their potential advantages, disadvantages and complications. It is evident that apart from the impending and pathological fracture surgery it is not the first choice of treatment but rather a palliative measure. The aim of surgery is to alleviate pain, to regain mobility and improve quality of life. If possible minimal invasive techniques are performed, as they are less demanding and allow fast rehabilitation for the patient, and they are solutions that last for a lifetime. In optimal conditions radical curative surgery can be performed in about 10 to 15 per cent of the cases, and better survival is encouraging.Keywords: metastatic bone diseases, diagnostic algorhythm, prognostic factors, extremity, pelvis, surgery for metastatic bone diseases

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“…In a recent meta-analysis, the median survival time of patients with castration-resistant prostate cancer and bone metastases was 21.3 months (3). In a 15-year study from the USA, more than half of patients with bone metastases from prostate cancer had evidence of SREs, either at diagnosis of bone metastases or subsequently (4).…”

Section: Introductionmentioning

confidence: 99%

Impact of intense systemic therapy and improved survival on the use of palliative radiotherapy in patients with bone metastases from prostate cancer

Nieder¹,

Haukland²,

Mannsåker³

et al. 2016

Oncology Letters

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Abstract. More effective drugs may reduce the requirement for palliative external beam radiotherapy for bony target volumes; however, living with metastases for prolonged periods of time may result in more frequent episodes of bone pain or serious skeletal-related events. The purpose of the present study was to evaluate how recent advances in systemic therapy impact radiotherapy utilization. A retrospective analysis of a comprehensive regional database was performed. All oncology care in this region was provided by only one center, assuring complete data. Patients that had succumbed between June 1, 2004 and June 1, 2015 were included. For all 236 patients, the median age at diagnosis of bone metastases was 75 years and median overall survival was 20 months. More intense systemic therapy was associated with a significantly longer survival time. Only 69 patients (29%) did not receive palliative radiotherapy for bony target volumes, whilst 1 course was given to 101 patients (43%), 2 courses to 34 patients (14%) and >2 courses to 32 patients (14%). Radiotherapy was used more frequently in younger patients, those with spinal cord compressions or pathological fractures, and those treated with intense and long-standing systemic therapy. Radiotherapy utilization increased with survival time. For 100 poor-prognosis patients that succumbed within 12 months, 57 courses of palliative radiotherapy were administered, whilst 100 patients that survived for 12-24 months were administered 114 courses (24-36 months, 148 courses). In conclusion, the use of palliative radiotherapy did not decrease when more effective systemic therapy was administered. However, provided that only 5% of patients received radionuclide treatment, additional studies in other populations are required.

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Natural history of skeletal-related events in patients with breast, lung, or prostate cancer and metastases to bone: a 15-year study in two large US health systems

Abstract: SREs are a frequent complication in patients with solid tumors and bone metastases, and are much more common than previously recognized in women with BC.

Cited by 147 publications

References 25 publications

Clinical Features and Risk Factors of Skeletal-Related Events in Genitourinary Cancer Patients with Bone Metastasis: A Retrospective Analysis of Prostate Cancer, Renal Cell Carcinoma, and Urothelial Carcinoma

Clinical Features and Risk Factors of Skeletal-Related Events in Genitourinary Cancer Patients with Bone Metastasis: A Retrospective Analysis of Prostate Cancer, Renal Cell Carcinoma, and Urothelial Carcinoma

Paradigmaváltás a csontmetasztázisok sebészetében. I. Végtagi és medencelokalizációjú áttétek

Impact of intense systemic therapy and improved survival on the use of palliative radiotherapy in patients with bone metastases from prostate cancer

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