DEMOGRAPHIC AND MORPHOLOGIC CHARACTERISTICS OF BONE METASTASES – 11 YEARS SINGLE CENTER EXPERIENCE

  • Vesna Janevska Institute for Pathology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.of North Macedonia
  • Milan Samardziski University Clinic for Orthopaedic Diseases, TOARILUC, Clinical Center Mother Theresa, Ss. Cyril and Methodius University in Skopje, R. of North Macedonia
  • Rubens Jovanovic Institute for Pathology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.of North Macedonia
  • Dafina Nikolova University Clinic for Gastroenterohepathology, Ss. Cyril and Methodius University in Skopje, R. of North Macedonia
  • Stefan Pandilov University Clinic for Eye Diseases, Ss. Cyril and Methodius University in Skopje, R. of North Macedonia
  • Vlatko Karanfilovski University Clinic for Nephrology, Ss. Cyril and Methodius University in Skopje, R. of North Macedonia

Abstract

This is an epidemiological study of bone metastasis (BM) diagnosed and treated in a period of 11 years. Age and sex distribution of BM, localization, origin of primary malignancy, plain radiography appearance, therapeutic options and survival of the patients were evaluated.  Of 86 patients, 52 were female and 34 male, ranging in age from 44 to 87 years.  The most common site of BM was femur, followed by spine and humerus, and the most common primary malignances were in the breast, lung, kidney and prostate, respectively. Almost one third of patients were with unknown primary malignancy at the time of BM diagnosis.The analysis of patients’ plain radiographies revealed that most BM were osteolytic lesions. Bisphosphonate therapy was applied in only 41.86% of patients, radiotherapy was applied in only 2.33% of patients and combination of bisphosphonates and radiotherapy received 8.14% of patients.The rest of the patients, 47.67%, were treated with symptomatic and/or with systemic therapy according to their primary malignancy.The survival analysis did not show statistically significant influence of any of the analyzed parameters in this study on the survival of the patients. Only 26.74% of patients survived 24 months and the high 73.26% survived 1 to 24 months.


Keywords: bone metastases, localization, primary malignancy, radiographic appearance, survival

References

1.Macedo F, Ladeira K, Pinho F, Saraiva N, Bonito N, Pinto L, Goncalves F. Bone Metastases: An Overview. Oncol Rev. 2017 May 9;11(1):321.
2.Wyant T, Alteri R, Kalidas M. Advanced and Metastatic Cancer. American Cancer Society. September, 2020; cancer.org 1.800.227.2345.
3.Cappuccio M, Bandiera S, Babbi L, Boriani L, Corghi A, Amendola L, Colangeli S et al. Management of bone metastases. European Review for Medical and Pharmacological Sciences. 2010; 14: 407-414.
4.Shibata H, Kato S, Sekine I, Abe K, Araki N, Izumi T, Inaba Y et al. Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology. ESMO Open.2016;1:e000037.doi:10.1136/esmoopen-2016-000037.
5.Onken SJ, Fekonja SL. Wehowsky R, Hubertus V, Vajkoczy P. Metastatic dissemination patterns of different primary tumors to the spine and other bones. Springer Nature B.V. 2019 Dec;36(6):493-498.
6.Jayarangaiah A, Kariyanna TP. Bone Metastasis. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507911
7.D'Oronzo S, Coleman R, Brown J, Silvestris F. Metastatic bone disease: Pathogenesis and therapeutic options up-date on bone metastasis management. J Bone Oncol. 2018 Nov 6;15:004-4.
8.Hernandez KR, Wade WS, Reich A, Pirolli M, Liede A, Lyman HG. Incidence of bone metastases in patients with solid tumors: analysis of oncology electronic medical records in the United States. BMC Cancer. 2018;18:44.
9.Ashford RU, Randall RL. Bone Metastases: Epidemiology and Societal Effect. In: Randall R. (eds) Metastatic Bone Disease. 2016; Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5662-9_1
10.Huang JF, Shen J, Li X, Rengan R, Silvestris N, Wang M, Derosa L et al. Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study. Ann Transl Med. 2020 Apr;8(7):482. doi: 10.21037/atm.2020.03.55. PMID: 32395526; PMCID: PMC7210217.
11.Piccioli A, Maccauro G, Spinelli MS, Biagini R, Rossi B. Bone metastases of unknown origin: epidemiology and principles of management. J Orthop Traumatol. 2015; 16(2):81–86.
12.Jabbar A R. Skeletal Metastasis: Distribution by Age, Sex and Histological Classification (Medical city). Iraqi Academic Scientific Journal.2013;12(2):192-195.
13.Li S, Peng Y, Weinhandl DE, Blaes HA, Cetin K, Chiaz MV, Stryker S et al. Estimated number of prevalent cases of metastatic bone disease in the US adult population. Clin Epidemiol. 2012;4:87-93. doi:10.2147/CLEP.S28339.
14.Zacharia B, Subramaniam D, Joy J. Skeletal Metastasis-an Epidemiological Study. Indian J Surg Oncol. 2018 Mar;9(1):46-51.
15.Parker SL, Tong T, Bolden S, Wingo PA. Cancer Statistics. CA Cancer J Clin. 1996;46:25-27.
16.Rougraff BT, Kneisl JS, Simon MA. Skeletal metastases of unknown origin. A prospective study of a diagnostic strategy. J.Bone Joint Surg Am. 1993; 75(9):1276–1281.
17.O'Sullivan GJ, Carty FL, Cronin CG. Imaging of bone metastasis: An update. World J Radiol. 2015;7(8):202-211. doi:10.4329/wjr.v7.i8.202.
18.Guise T. Examining the Metastatic Niche: Targeting the Microenvironment. Seminars in Oncology, Vol 37, No 5, Suppl 2, October 2010, pp S2-S14.
19.Masatsugu I, Hellman J, Cockett TKA, Lilja H, Gershagen S. Alteration of the hormonal bioactivity of parathyroid hormone-related protein (PTHrP) as a result of limited proteolysis by prostate-specific antigen. Urollogy basic science, volume 48, issue 2. 1996; p317-325.
20.Nørgaard M, Jensen AØ, Jacobsen JB, Cetin K, Fryzek JP, Sørensen HT. Skeletal related events, bone metastasis and survival of prostate cancer: a population based cohort study in Denmark (1999 to 2007). J Urol. 2010;184:162–7.
21.Wiren KM, Zhang XW, Olson DA, Turner RT, Iwaniec UT. Androgen prevents hypogonadal bone loss via inhibition of resorption mediated by mature osteoblasts/osteocytes. Bone. 2012;51(5):835–46.
22.Sinnesael M, Claessens F, Laurent M, Dubois V, Boonen S, Deboel L, Vanderschueren D. Androgen receptor (AR) in osteocytes is important for the maintenance of male skeletal integrity: evidence from targeted AR disruption in mouse osteocytes. J Bone Miner Res. 2012;27(12):2535–43.
23.Chiang C, Chiu M, Moore AJ, Anderson PH, Ghasem-Zadeh A, McManus JF, Ma Cet al. Mineralization and bone resorption are regulated by the androgen receptor in male mice. J Bone Miner Res. 2009;24(4):621–31.
24.Argentiero A, Solimando AG, Brunetti O, Calabrese A, Pantano F, Luliani M, Santini D et al. Skeletal Metastases of Unknown Primary: Biological Landscape and Clinical Overview. Cancers (Basel). 2019;11(9):1270. Published 2019 Aug 29. doi:10.3390/cancers11091270.
25.Hamaoka T, Medewell EJ, Podoloff AD, Hotobagyi NG, Ueno TU. Bone Imaging in Metastatic Breast Cancer. Journal of Clinical Oncology 2004;22(14):2942-2953
Published
2021-03-16
How to Cite
JANEVSKA, Vesna et al. DEMOGRAPHIC AND MORPHOLOGIC CHARACTERISTICS OF BONE METASTASES – 11 YEARS SINGLE CENTER EXPERIENCE. Journal of Morphological Sciences, [S.l.], v. 4, n. 1, p. 65-76, mar. 2021. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/181>. Date accessed: 28 july 2021.
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Articles