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

September-October 2014 Volume 2 Issue 5

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September-October 2014 Volume 2 Issue 5

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Article

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

Authors:
- Hirofumi Shimada
- Takao Setoguchi
- Masahiro Yokouchi
- Hiromi Sasaki
- Yasuhiro Ishidou
- Ichiro Kawamura
- Masahiko Abematsu
- Satoshi Nagano
- Setsuro Komiya
View Affiliations / Copyright

Affiliations: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890‑8520, Japan, The Near‑Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890‑8520, Japan, Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890‑8520, Japan
Pages: 875-881
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Published online on: June 23, 2014

https://doi.org/10.3892/mco.2014.326
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Abstract

We analyzed the prognostic factors in patients with metastatic bone tumors and evaluated the efficacy of different modalities in identifying the primary lesions. A total of 145 patients with bone metastases who attended the orthopaedic outpatient clinic were included in this study. The most frequent site of bone metastases was the spine. The primary tumor type was differently distributed between patients with a known primary tumor at the first visit and those with an unknown primary lesion. The number of breast cancer cases was statistically significantly lower in the primary‑unknown group. However, the number of myeloma cases was significantly higher in the primary‑unknown group. Survival was significantly lower in the skeletal‑related events (SREs) compared to that in the non‑SREs group. Furthermore, survival was significantly worse in patients with a performance status (PS) of ≥2 compared to those with a PS of ≤1 and neurological complications occurred statistically more often in the group with worse PS (≥2). Survival rates were significantly lower in the non‑spinal compared to those in the spinal metastatic group. Since the majority of breast cancer patients presented with metastasis in the spine, a breast cancer origin was a positive prognostic factor in patients with spinal metastases. Although there were no significant differences between computed tomography (CT) and 18F‑fluoro‑2‑deoxyglucose (18F‑FDG) positron emission tomography (PET)‑CT in detecting primary lesions, CT may be the first choice due to its feasibility. In conclusion, lung cancer, SREs and worse PS were adverse prognostic factors for patients with bone metastasis. In addition, CT scans may be more useful for determining the primary lesion of a bone metastasis compared to 18F‑FDG PET‑CT in a timelier manner.

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1	Coleman RE: Bisphosphonates: clinical experience. Oncologist. 9(Suppl 4): 14–27. 2004. View Article : Google Scholar
2	Lipton A, Colombo-Berra A, Bukowski RM, Rosen L, Zheng M and Urbanowitz G: Skeletal complications in patients with bone metastases from renal cell carcinoma and therapeutic benefits of zoledronic acid. Clin Cancer Res. 10:6397S–6403S. 2004. View Article : Google Scholar : PubMed/NCBI
3	Destombe C, Botton E, Le Gal G, et al: Investigations for bone metastasis from an unknown primary. Joint Bone Spine. 74:85–89. 2007. View Article : Google Scholar : PubMed/NCBI
4	Iizuka Y, Iizuka H, Tsutsumi S, et al: Diagnosis of a previously unidentified primary site in patients with spinal metastasis: diagnostic usefulness of laboratory analysis, CT scanning and CT-guided biopsy. Eur Spine J. 18:1431–1435. 2009. View Article : Google Scholar
5	Katagiri H, Takahashi M, Inagaki J, Sugiura H, Ito S and Iwata H: Determining the site of the primary cancer in patients with skeletal metastasis of unknown origin: a retrospective study. Cancer. 86:533–537. 1999. View Article : Google Scholar : PubMed/NCBI
6	Kakhki VR, Anvari K, Sadeghi R, Mahmoudian AS and Torabian-Kakhki M: Pattern and distribution of bone metastases in common malignant tumors. Nucl Med Rev Cent East Eur. 16:66–69. 2013. View Article : Google Scholar : PubMed/NCBI
7	Bartels RH, van der Linden YM and van der Graaf WT: Spinal extradural metastasis: review of current treatment options. CA Cancer J Clin. 58:245–259. 2008. View Article : Google Scholar : PubMed/NCBI
8	Harel R and Angelov L: Spine metastases: current treatments and future directions. Eur J Cancer. 46:2696–2707. 2010. View Article : Google Scholar : PubMed/NCBI
9	Sutcliffe P, Connock M, Shyangdan D, Court R, Kandala NB and Clarke A: A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression. Health Technol Assess. 17:1–274. 2013. View Article : Google Scholar
10	Oken MM, Creech RH, Tormey DC, et al: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 5:649–655. 1982. View Article : Google Scholar : PubMed/NCBI
11	Katagiri H, Takahashi M, Wakai K, Sugiura H, Kataoka T and Nakanishi K: Prognostic factors and a scoring system for patients with skeletal metastasis. J Bone Joint Surg Br. 87:698–703. 2005. View Article : Google Scholar : PubMed/NCBI
12	Delank KS, Wendtner C, Eich HT and Eysel P: The treatment of spinal metastases. Dtsch Arztebl Int. 108:71–80. 2011.
13	Al-Brahim N, Ross C, Carter B and Chorneyko K: The value of postmortem examination in cases of metastasis of unknown origin - 20-year retrospective data from a tertiary care center. Ann Diagn Pathol. 9:77–80. 2005.PubMed/NCBI
14	Blaszyk H, Hartmann A and Bjornsson J: Cancer of unknown primary: clinicopathologic correlations. APMIS. 111:1089–1094. 2003. View Article : Google Scholar : PubMed/NCBI
15	Rougraff BT, Kneisl JS and Simon MA: Skeletal metastases of unknown origin. A prospective study of a diagnostic strategy. J Bone Joint Surg Am. 75:1276–1281. 1993.PubMed/NCBI
16	Han A, Xue J, Hu M, Zheng J and Wang X: Clinical value of ¹⁸F-FDG PET-CT in detecting primary tumor for patients with carcinoma of unknown primary. Cancer Epidemiol. 36:470–475. 2012.
17	Ecker RD, Endo T, Wetjen NM and Krauss WE: Diagnosis and treatment of vertebral column metastases. Mayo Clin Proc. 80:1177–1186. 2005. View Article : Google Scholar : PubMed/NCBI
18	Sciubba DM, Petteys RJ, Dekutoski MB, et al: Diagnosis and management of metastatic spine disease. A review. J Neurosurg Spine. 13:94–108. 2010. View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

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

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