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Bone metastasis from gastric cancer: the incidence, clinicopathological features, and influence on survival.

Turkoz FP, Solak M, Kilickap S, Ulas A, Esbah O, Oksuzoglu B, Yalcin S - J Gastric Cancer (2014)

Bottom Line: On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times.In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors.Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.

View Article: PubMed Central - PubMed

Affiliation: Ataturk Chest Disease and Chest Surgery Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.

ABSTRACT

Purpose: To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases.

Materials and methods: Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed.

Results: The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors.

Conclusions: Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.

No MeSH data available.


Related in: MedlinePlus

Overall survival of patients with and without isolated bone metastasis. OS-BM = overall survival after developing bone metastasis.
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Figure 2: Overall survival of patients with and without isolated bone metastasis. OS-BM = overall survival after developing bone metastasis.

Mentions: In the overall study population, the 2-year OS rates were 31%, 21%, and 3% for patients with stage II, III, and IV GC, respectively (Plog-rank<0.001). The median OS and OS-BM were 13.8 months (95% CI, 11.5~16.1) and 5.4 months (95% CI, 4.0~6.9), respectively (Fig. 1). The median follow-up time after bone metastasis was 27.5 months (range, 1~56.5 months). The patients with isolated bone metastases had longer OS (27.1 vs. 11.9 months; Plog-rank<0.001) and OS-BM (20.4 vs. 8.5 months; Plog-rank=0.004) than the patients who had both bone and concomitant non-bone metastases (Fig. 2). No significant differences were found in OS and OS-BM between the patients with solitary and multiple bone metastases (18.2 vs. 13.2 months; Plog-rank=0.266, and 5.9 vs. 5.4 months; Plog-rank=0.153, respectively). The median OS-BM was also similar between the patients with synchronous and metachronous bone metastases (4.3 vs. 5.3 months; Plog-rank=0.124).


Bone metastasis from gastric cancer: the incidence, clinicopathological features, and influence on survival.

Turkoz FP, Solak M, Kilickap S, Ulas A, Esbah O, Oksuzoglu B, Yalcin S - J Gastric Cancer (2014)

Overall survival of patients with and without isolated bone metastasis. OS-BM = overall survival after developing bone metastasis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199883&req=5

Figure 2: Overall survival of patients with and without isolated bone metastasis. OS-BM = overall survival after developing bone metastasis.
Mentions: In the overall study population, the 2-year OS rates were 31%, 21%, and 3% for patients with stage II, III, and IV GC, respectively (Plog-rank<0.001). The median OS and OS-BM were 13.8 months (95% CI, 11.5~16.1) and 5.4 months (95% CI, 4.0~6.9), respectively (Fig. 1). The median follow-up time after bone metastasis was 27.5 months (range, 1~56.5 months). The patients with isolated bone metastases had longer OS (27.1 vs. 11.9 months; Plog-rank<0.001) and OS-BM (20.4 vs. 8.5 months; Plog-rank=0.004) than the patients who had both bone and concomitant non-bone metastases (Fig. 2). No significant differences were found in OS and OS-BM between the patients with solitary and multiple bone metastases (18.2 vs. 13.2 months; Plog-rank=0.266, and 5.9 vs. 5.4 months; Plog-rank=0.153, respectively). The median OS-BM was also similar between the patients with synchronous and metachronous bone metastases (4.3 vs. 5.3 months; Plog-rank=0.124).

Bottom Line: On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times.In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors.Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.

View Article: PubMed Central - PubMed

Affiliation: Ataturk Chest Disease and Chest Surgery Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey.

ABSTRACT

Purpose: To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases.

Materials and methods: Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed.

Results: The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors.

Conclusions: Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.

No MeSH data available.


Related in: MedlinePlus