Neoplastic fever in patients with bone and soft tissue sarcoma

Nakamura,Tomoki; Matsumine,Akihiko; Matsubara,Takao; Asanuma,Kunihiro; Sudo,Akihiro

doi:10.3892/mco.2016.1027

Neoplastic fever in patients with bone and soft tissue sarcoma

Authors:
- Tomoki Nakamura
- Akihiko Matsumine
- Takao Matsubara
- Kunihiro Asanuma
- Akihiro Sudo
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Affiliations: Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514‑8507, Japan
Published online on: September 21, 2016 https://doi.org/10.3892/mco.2016.1027
Pages: 631-634

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Abstract

The development of fever is a common complication in the clinical course of cancer. If all other potential causes of fever are excluded, the possibility of neoplastic fever should be considered. The aim of the present study was to determine the incidence of neoplastic fever in patients with bone and soft tissue sarcomas. Between January 2009 and December 2014, 195 patients with bone and soft tissue sarcoma (111 men and 84 women; mean age, 55 years) were admitted to the department of Orthopaedic Surgery of Mie University Graduate School of Medicine (Tsu, Japan). Episodes of fever were observed in 58 patients (30%), of whom 11 (5.5%) had neoplastic fever (mean maximum temperature, 38.9˚C). The causes of neoplastic fever were as follows: primary tumor (n=3), local recurrence (n=1), metastasis (n=5), and local recurrence with metastasis (n=2). Of the 11 patients, 9 were treated with naproxen and 8 exhibited a complete response, with their temperature normalizing to <37.3˚C within 24 h. The 2 patients who were not treated with naproxen underwent surgical tumor resection, which resulted in prompt and complete lysis of the fever. In conclusion, neoplastic fever occurred in 5.5% of the 195 patients with bone and soft tissue sarcomas investigated herein. naproxen may be effective for treating neoplastic fever in patients with bone and soft tissue sarcoma; however, radical tumor treatment may have to be considered to achieve permanent lysis of the fever.

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1	Toussaint E, Bahel-Ball E, Vekemans M, Georgala A, Al-Hakak L, Paesmasns M and Aoun M: Cause of fever in cancer patients (prospective study over 477 episodes). Support Care Cancer. 14:763–769. 2006. View Article : Google Scholar : PubMed/NCBI
2	Nachman JB and Honig GR: Fever and neutropenia in children with neoplastic disease: An analysis of 158 episodes. Cancer. 45:407–412. 1980. View Article : Google Scholar : PubMed/NCBI
3	Pagano L, Caira M, Rossi G, Tumbarello M, Fanci R, Garzia MG, Vianelli N, Filardi N, De Fabritiis P, Beltrame A, et al: A prospective survey of febrile events in hematological malignancies. Ann Hematol. 91:767–774. 2012. View Article : Google Scholar : PubMed/NCBI
4	Park S, Kang CI, Chung DR, Peck KR, Kim WS and Kim SJ: Clinical significance of non-neutropenic fever in the management of diffuse large B-cell lymphoma patients treated with rituximab-CHOP: Comparison with febrile neutropenia and risk factor analysis. Cancer Res Treat. 47:448–457. 2015. View Article : Google Scholar : PubMed/NCBI
5	Bacci G, Ferrari S, Longhi A, Picci P, Mercuri M, Alvegard TA, Saeter G, Donati D, Manfrini M, Lari S, et al: High-dose ifosfamide in combination with high-dose methotrexate, adriamycin and cysplatin in the neoadjuvant treatment of extremity osteosarcoma: Preliminary results of an Italian Sarcoma Group/Scandinavian Sarcoma Group pilot study. J Chemother. 14:198–206. 2002. View Article : Google Scholar : PubMed/NCBI
6	Lewin J, Wieringa S, Collins M, Desai J, Orme L, Lingaratnam S and Thomas DM: Intra-patient dose escalation in Ewing's sarcoma treated with vincristine, doxorubicin, cyclophosphamide alternating with ifosfamide and etoposide: A retrospective review. Clin Sarcoma Res. 3:152013. View Article : Google Scholar : PubMed/NCBI
7	Schmitt T, Lehner B, Kasper B, Bischof M, Roeder F, Dietrich S, Dimitrakopoulou-Strauss A, Strauss LG, Mechtersheimer G, Wuchter P, et al: A phase II study evaluating neo/adjuvant EIA chemotherapy, surgical resection and radiotherapy in high-risk soft tissue sarcoma. BMC Cancer. 11:5102011. View Article : Google Scholar : PubMed/NCBI
8	Kalofonos HP, Kourousis C, Karamouzis MV, Iconomou G, Tsiata E, Tzorzidis F, Megas P, Lambiris E and Georgoulias V: A phase II study of docetaxel and epirubicin in advanced adult soft tissue sarcomas (STS). Sarcoma. 8:129–133. 2004. View Article : Google Scholar : PubMed/NCBI
9	Judson I, Verweij J, Gelderblom H, Hartmann JT, Schöffski P, Blay JY, Kerst JM, Sufliarsky J, Whelan J, Hohenberger P, et al: Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: A randomised controlled phase 3 trial. Lancet Oncol. 15:415–423. 2014. View Article : Google Scholar : PubMed/NCBI
10	Morii T, Mochizuki K, Tajima T, Ichimura S and Satomi K: Surgical site infection in malignant soft tissue tumors. J Orthop Sci. 17:51–57. 2012. View Article : Google Scholar : PubMed/NCBI
11	Nakamura T, Matsumine A, Matsubara T, Asanuma K, Uchida A and Sudo A: Clinical characteristic of patients with large and deep soft tissue sarcomas. Oncol Lett. 10:841–844. 2015.PubMed/NCBI
12	Nakamura T, Matsumine A, Uchida A, Kawai A, Nishida Y, Kunisada T, Araki N, Sugiura H, Tomita M, Yokouchi M, et al: Clinical outcomes of Kyocera Modular Limb Salvage System after resection of bone sarcoma of distal part of the femur: The Japanese Musculoskeletal Oncology Group Study. Int Orthop. 38:825–830. 2014. View Article : Google Scholar : PubMed/NCBI
13	Zell JA and Chang JC: Neoplastic fever: A neglected paraneoplastic syndrome. Support Care Cancer. 13:870–877. 2005. View Article : Google Scholar : PubMed/NCBI
14	Dinarello CA and Bunn PA Jr: Fever. Semin Oncol. 24:288–298. 1997.PubMed/NCBI
15	Chang JC and Gross HM: Neoplastic fever responds to the treatment of an adequate dose of naproxen. J Clin Oncol. 3:552–558. 1985.PubMed/NCBI
16	Johnson M: Neoplastic fever. Palliat Med. 10:217–224. 1996. View Article : Google Scholar : PubMed/NCBI
17	Browder AA, Huff JW and Petersdorf RG: The significance of fever in neoplastic disease. Ann Intern Med. 55:932–942. 1961. View Article : Google Scholar : PubMed/NCBI
18	Osaka S, Fujimoto Y, Yamazaki H, Suzuki K, Sawada S and Hayashi N: Interleukin-1 alpha producing synovial sarcoma with prolonged fever: A case report. Jpn J Clin Oncol. 28:436–440. 1998. View Article : Google Scholar : PubMed/NCBI
19	Hamada T, Komiya S, Hiraoka K, Zenmyo M, Morimatsu M and Inoue A: IL-6 in a pleomorphic type of malignant fibrous histiocytoma presenting high fever. Hum Pathol. 29:758–761. 1998. View Article : Google Scholar : PubMed/NCBI
20	Osaka S, Hayakawa S, Yoshida Y, Sakurada E, Ryu J and Sugitani M: Interleukin-8 producing malignant fibrous histiocytoma with prolonged fever. Acta Histochem Cytochem. 39:17–21. 2006. View Article : Google Scholar : PubMed/NCBI
21	Freifeld AG, Bow EJ, Sepkowitz KA, et al: the Infectious Diseases Society of America: Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 52:e56–e93. 2011. View Article : Google Scholar : PubMed/NCBI
22	Kiyosawa T, Higaki H and Nakayama Y: Liposarcoma associated with fever and reversible hepatic dysfunction. Int J Dermatol. 36:132–134. 1997. View Article : Google Scholar : PubMed/NCBI
23	Chang JC: Antipyretic effect of naproxen and corticosteroids on neoplastic fever. J Pain Symptom Manage. 3:141–144. 1988. View Article : Google Scholar : PubMed/NCBI
24	Coussens LM and Werb Z: Inflammation and cancer. Nature. 420:860–867. 2002. View Article : Google Scholar : PubMed/NCBI
25	Mantovani G, Maccio A, Pisano M, et al: Tumor-associated lympho-monocytes from neoplastic effusions are immunologically defective in comparison with patients autologous PBMCs are capable of releasing high amounts of various cytokines. Int J Cancer. 71:724–731. 1997. View Article : Google Scholar : PubMed/NCBI
26	Nakanishi H, Yoshikawa K, Joyama S, et al: Interleukin-6/soluble interleukin-6 receptor signaling attenuated proliferation and invasion, and induces morphological changes of a newly established pleomorphic malignant fibrous histiocytoma cell line. Am J Pathol. 165:471–480. 2004. View Article : Google Scholar : PubMed/NCBI
27	Kathula SK, Shah K, Polenakovik H and Koduri J: Cyclo-oxygenase II inhibitors in the treatment of neoplastic fever. Support Care Cancer. 11:258–259. 2003.PubMed/NCBI
28	Tsavaris N, Zinelis A, Karabelis S, Beldecos D, Bacojanis C, Milonacis N, Karvounis N and Kosmidis P: A randomized trial of the effect of three non-steroid anti-inflammatory agents in ameliorating cancer-induced fever. J Intern Med. 228:451–455. 1990. View Article : Google Scholar : PubMed/NCBI