Clinicopathological characteristics in patients with bone metastasis in GI cancers

Abstract

Listen

Translate article

Introduction: The QOL of patients who have bone metastasis of malignant tumor is spoiled remarkably, not only the metastasis of one simple organ, but also almost all cases needed to admission to treat for its symptom. We aimed to reveal clinicopathological finding in GI Cancers. Methods: 144 patients with GI cancer in our hospital from January 2006 to July 2013 were analyzed. All of the 144 cases confirmed bone metastasis examined by CT and/or MRI and/or bone scintigraphy. We checked all case of medical record retrospectively and collect patient characteristics, clinical data and treatment regimens. Results: M/F 103/41, median age 66 years (30-84), primary lesion were 58 stomach cancer, 35 liver cancer, 14 esophageal cancer, 13 pancreatic cancer, 15 colon cancer, 8 bile duct cancer and 1 duodenal cancer. The patients who were treated was 111/144 (77%), chemotherapy were selected 90 cases. The median of the serum ALP level was 502 (104-40890) IU/L before treatment, 105 cases (73%) were exceeded and 39 cases (27%) still ranged in the standard value. The median of the serum LDH level was 246(91-3284) IU/L. The median survival time in all 131 cases was 129 days. The univariate analysis for factor which prescribed prognosis showed the treatment (P < 0.000), chemotherapy (P < 0.000) and high serum LDH level (P < 0.000) were statistically different. In 106 cases were able to chase at least two point of serum ALP level since diagnosed bone metastasis before treatment and treated after two months. The ALP ratio (post 2M ALP/pre ALP) was calculated and patients who decreased ALP ratio had good prognosis compared to others (P = 0.018). In 32 of 58 cases of stomach cancer received the zoledronic acid +/- chemotherapy. The zoledronic acid administrated group had good prognosis compared to others (P = 0.017). The treatment was chosen for the multivariate analysis (P = 0.001). Conclusion: These data suggested that it is important to survey bone metastasis and perform an examination for image in GI cancers. The ALP ratio can be a one of prognostic marker for patients with bone metastasis. In addition, the possibility with the prognostic improvement effect was thought about for bone metastasis patient by treated with the zoledronic acid.