Lessons learned from 15-year of radionuclide bone scan in cancer context at Yaoundé General Hospital (Cameroon) (+ Running poster)

Abstract

In our setting, patients come lately to cancer treatment centres. The introduction of radionuclide scan in 2004 has had a great contribution to the diagnosis of bone metastases. To take stock of fifteen years of bone exploration in cancer context in our setting. A 15-year retrospective study with 1278 patients who performed each a radionuclide bone scan for different cancers, from 2004 to 2019 in our national reference centre. All 99mTc-MDP bone scans were performed on a Siemens® gamma-camera with a low energy high-resolution collimator. Collected data were analysed using SPSS® software with significant P -value < 0.05. Ages ranged from 15 to 92 years with a mean of 55.9 ± 15.9 and a 1.34 sex ratio. The modal age group was 50 to 70 years (39.36%). The major cancers were prostate (49.68%), breast (31.77%) and cervix (5.16%) cancers. The average duration since the diagnosis of cancer was 25.7 months. Positive bone scans accounted for 40.77% and the presence of bone metastases revealed an unknown cancer in 9.79%. The main affected sites were chest (79.27%), spine (78.31%) and pelvis (71.01%). In 26.49% of positive cases, there was no clinical sign of bone disease. According to Soloway and SWOG's classifications, the prognosis was poor in 70.06% and 66.22%, respectively. Prostate cancer was the most pejorative and cervix cancer was the one with the best prognosis ( P = 0.0014). Bone metastases are present in almost half of cases of cancers, even in absence of clinical signs. Axial bones, mainly chest, spine and pelvis, are the preferential sites. Ten percent of cancers are revealed by bone metastases. In 2/3 of cases, the prognosis is pejorative, especially for prostate cancer. We recommend that clinicians become more aware of the systematic search of bone extension as soon as the cancer is diagnosed.