Acta ortopedica mexicana · 2025
Bone metastasis patterns in solid cancers at a tertiary cancer center.
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Rosas L C, García-Ortega D Y, Clara-Altamirano M A, Martínez-Said H, Villavicencio-Valencia V, Meléndez-Fernández A P, González-Prieto R E, González-Álvarez C, Cuellar-Hubbe M
Аннотация
INTRODUCTION: Metastatic Bone Cancer (MBC) is the most common malignancy affecting the skeletal system. The cancers that most frequently metastasize to bone include breast, prostate, lung, kidney, and thyroid cancers (comprising 70% of cases). Metastatic patterns are classified as lytic, blastic, or mixed lesions, often affecting the axial skeleton.
MATERIALS AND METHODS: this retrospective cohort study included patients with MBC treated between January 1, 2012, and December 31, 2022. Patients over 17 years of age with a diagnosis of solid neoplasia and evidence of metastatic bone disease confirmed by plain radiographs, computed tomography, magnetic resonance imaging, or PET-CT were included. Patients who died from causes unrelated to cancer and those who discontinued follow-up were excluded. Statistical analysis: we performed a descriptive analysis of demographic variables and used a Cox regression model, incorporating variables adapted to the model. Overall Survival (OS) was evaluated using the Kaplan-Meier method.
RESULTS: we analyzed data from 902 patients with a median age of 61 years. The majority were male (54.4%). Multiple lesions (three or more) were found in 49% of cases, primarily in the axial skeleton. Prostate cancer was the most common primary cancer (32%), while lytic lesions were most often associated with lung cancer (38%). Additionally, 153 patients (17%) had pathological fractures, 77% experienced pain secondary to Hypercalcemia of Malignancy (HCM), and 59% had metastases in organs other than bone. The median OS was 15 months.
CONCLUSIONS: bone metastases are a poor prognostic factor in cancer patients and negatively impact quality of life. Identifying and understanding metastatic patterns is essential for developing effective therapeutic strategies and innovative treatments.
MATERIALS AND METHODS: this retrospective cohort study included patients with MBC treated between January 1, 2012, and December 31, 2022. Patients over 17 years of age with a diagnosis of solid neoplasia and evidence of metastatic bone disease confirmed by plain radiographs, computed tomography, magnetic resonance imaging, or PET-CT were included. Patients who died from causes unrelated to cancer and those who discontinued follow-up were excluded. Statistical analysis: we performed a descriptive analysis of demographic variables and used a Cox regression model, incorporating variables adapted to the model. Overall Survival (OS) was evaluated using the Kaplan-Meier method.
RESULTS: we analyzed data from 902 patients with a median age of 61 years. The majority were male (54.4%). Multiple lesions (three or more) were found in 49% of cases, primarily in the axial skeleton. Prostate cancer was the most common primary cancer (32%), while lytic lesions were most often associated with lung cancer (38%). Additionally, 153 patients (17%) had pathological fractures, 77% experienced pain secondary to Hypercalcemia of Malignancy (HCM), and 59% had metastases in organs other than bone. The median OS was 15 months.
CONCLUSIONS: bone metastases are a poor prognostic factor in cancer patients and negatively impact quality of life. Identifying and understanding metastatic patterns is essential for developing effective therapeutic strategies and innovative treatments.