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The Impact of Lung Carcinoma Histology on the Frequency of Bone Metastases[*]Article in several languages: português | English
12 September 2017
21 February 2018
19 September 2019 (online)
Objective Lung cancer is the leading cause of death by cancer, and the bones are one of the most common sites of metastasis from this condition. This study aimed to evaluate the influence of lung carcinoma histology on the frequency of bone metastases.
Methods This retrospective study evaluated the medical records of 407 patients diagnosed with lung cancer between 2003 and 2012. The prevalence of bone metastases and their association with histological subtypes were evaluated using chi-squared tests, odds ratios (ORs) and 95% confidence intervals (CIs). The overall survival was evaluated using the Kaplan-Meier method.
Results The prevalence of bone metastases was 28.2% (n = 115), and the spine was the most frequently affected site (98 metastases; 32.1%). Adenocarcinoma was the most common histological subtype of lung carcinoma (46.7%), and it was significantly more frequent among patients with bone metastases (58.3% versus 42.1%; p = 0.003; OR = 1.92; 95% CI: 1.29–2.97). Squamous cell carcinoma was significantly less frequent among patients with bone metastases (13.0% versus 29.8%; p = 0.0004; OR = 0.35; 95% CI: 0.19–0.64). The median survival time after the first bone metastasis diagnosis was 4 months.
Conclusion Adenocarcinoma was the most common histological subtype of lung carcinoma, and it was significantly associated with a higher risk of developing bone metastases.
* Work performed at Trauma and Orthopedics Service, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. Originally published by Elsevier Ltda.
- 1 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015; 65 (01) 5-29
- 2 Malta DC, Moura L, Souza MF, Curado MP, Alencar AP, Alencar GP. Tendência de mortalidade do câncer de pulmão, traquéia e brônquios no Brasil, 1980–2003. J Bras Pneumol 2007; 33 (05) 536-543
- 3 Novaes FT, Cataneo DC, Ruiz Junior RL, Defaveri J, Michelin OC, Cataneo AJM. Lung cancer: histology, staging, treatment and survival. J Bras Pneumol 2008; 34 (08) 595-600
- 4 Sugiura H, Yamada K, Sugiura T, Hida T, Mitsudomi T. Predictors of survival in patients with bone metastasis of lung cancer. Clin Orthop Relat Res 2008; 466 (03) 729-736
- 5 Katagiri H, Takahashi M, Wakai K, Sugiura H, Kataoka T, Nakanishi K. Prognostic factors and a scoring system for patients with skeletal metastasis. J Bone Joint Surg Br 2005; 87 (05) 698-703
- 6 Langer C, Hirsh V. Skeletal morbidity in lung cancer patients with bone metastases: demonstrating the need for early diagnosis and treatment with bisphosphonates. Lung Cancer 2010; 67 (01) 4-11
- 7 Kuchuk M, Addison CL, Clemons M, Kuchuk I, Wheatley-Price P. Incidence and consequences of bone metastases in lung cancer patients. J Bone Oncol 2013; 2 (01) 22-29
- 8 Avelino CU, Cardoso RM, Aguiar SS, Silva MJ. Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel. J Bras Pneumol 2015; 41 (02) 133-142
- 9 Sun JM, Ahn JS, Lee S. , et al. Predictors of skeletal-related events in non-small cell lung cancer patients with bone metastases. Lung Cancer 2011; 71 (01) 89-93
- 10 Tsuya A, Kurata T, Tamura K, Fukuoka M. Skeletal metastases in non-small cell lung cancer: a retrospective study. Lung Cancer 2007; 57 (02) 229-232
- 11 Cetin K, Christiansen CF, Jacobsen JB, Nørgaard M, Sørensen HT. Bone metastasis, skeletal-related events, and mortality in lung cancer patients: a Danish population-based cohort study. Lung Cancer 2014; 86 (02) 247-254
- 12 Lorusso V, Duran I, Garzon-Rodriguez C. , et al. Health resource utilisation associated with skeletal-related events in European patients with lung cancer: a subgroup analysis from a prospective multinational study. Mol Clin Oncol 2014; 2 (05) 701-708
- 13 Kagohashi K, Satoh H, Ishikawa H, Ohtsuka M, Sekizawa K. Bone metastasis as the first manifestation of lung cancer. Int J Clin Pract 2003; 57 (03) 184-186
- 14 Oliveira MB, Mello FC, Paschoal ME. The relationship between lung cancer histology and the clinicopathological characteristics of bone metastases. Lung Cancer 2016; 96 (01) 19-24
- 15 Travis WD, Brambilla E, Noguchi M. , et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol 2011; 6 (02) 244-285
- 16 Lee DS, Kang JH, Lee CG. , et al. Predicting survival in patients with advanced non-squamous non-small cell lung cancer: validating the extent of metastasis. Cancer Res Treat 2013; 45 (02) 95-102
- 17 Yu JL, Simmons C, Victor JC. , et al. Impact of new chemotherapeutic and targeted agents on survival in stage IV non-small cell lung cancer. Oncologist 2011; 16 (09) 1307-1315
- 18 Quint LE, Tummala S, Brisson LJ. , et al. Distribution of distant metastases from newly diagnosed non-small cell lung cancer. Ann Thorac Surg 1996; 62 (01) 246-250
- 19 Salvatierra A, Baamonde C, Llamas JM, Cruz F, Lopez-Pujol J. Extrathoracic staging of bronchogenic carcinoma. Chest 1990; 97 (05) 1052-1058
- 20 Michel F, Solèr M, Imhof E, Perruchoud AP. Initial staging of non-small cell lung cancer: value of routine radioisotope bone scanning. Thorax 1991; 46 (07) 469-473
- 21 Tornyos K, Garcia O, Karr B, LeBeaud R. A correlation study of bone scanning with clinical and laboratory findings in the staging of nonsmall-cell lung cancer. Clin Nucl Med 1991; 16 (02) 107-109
- 22 Kosteva J, Langer C. Incidence and distribution of skeletal metastases in NSCLC in the era of PET. Lung Cancer 2004; 46 (Suppl. 01) S45
- 23 Sekine I, Nokihara H, Yamamoto N, Kunitoh H, Ohe Y, Tamura T. Risk factors for skeletal-related events in patients with non-small cell lung cancer treated by chemotherapy. Lung Cancer 2009; 65 (02) 219-222
- 24 Janssen-Heijnen ML, Coebergh JW. The changing epidemiology of lung cancer in Europe. Lung Cancer 2003; 41 (03) 245-258
- 25 Charloux A, Quoix E, Wolkove N, Small D, Pauli G, Kreisman H. The increasing incidence of lung adenocarcinoma: reality or artefact? A review of the epidemiology of lung adenocarcinoma. Int J Epidemiol 1997; 26 (01) 14-23
- 26 Westphal FL, Lima LC, Andrade EC, Lima Netto JC, Silva AS, Carvalho BC. Características de pacientes com câncer de pulmão na cidade de Manaus. J Bras Pneumol 2009; 35 (02) 157-163
- 27 Heidemann F, Schildt A, Schmid K. , et al. Selectins mediate small cell lung cancer systemic metastasis. PLoS One 2014; 9 (04) e92327
- 28 Sathiakumar N, Delzell E, Morrisey MA. , et al. Mortality following bone metastasis and skeletal-related events among patients 65 years and above with lung cancer: A population-based analysis of U.S. Medicare beneficiaries, 1999-2006. Lung India 2013; 30 (01) 20-26
- 29 Bae HM, Lee SH, Kim TM. , et al. Prognostic factors for non-small cell lung cancer with bone metastasis at the time of diagnosis. Lung Cancer 2012; 77 (03) 572-577
- 30 Hansen BH, Keller J, Laitinen M. , et al. The Scandinavian Sarcoma Group Skeletal Metastasis Register. Survival after surgery for bone metastases in the pelvis and extremities. Acta Orthop Scand Suppl 2004; 75 (311) 11-15