Existence Of Bone Metastasis Research Articles

Clinical Influence of Ploidy and Cancer Stem Cells and Other Parameters in Stage IV Colorectal Cancer.

The aim of the present study was the evaluation of the influence of cancer stem cells and other parameters in stage IV colorectal cancer patients. One hundred patients were retrospectively included in the study and 24 variables were examined for their relation with response to treatment and survival. A low ploidy score in the histology of colorectal cancer was associated with improvement of performance status and response to therapy. No significant correlations between the percentage of cancer stem cells from the same tissue and the remaining clinical parameters was revealed. In the multivariate analysis of all the examined parameters in Cox models, independent unfavorable prognostic factors were increased ploidy score, existence of bone metastases, use of epoetin, and existence of side-effects such as anorexia, mucositis, and weight loss. Our findings emphasize on the prognostic role of ploidy in advanced colorectal cancer, but further analysis is required to evaluate the role of cancer stem cells.

P1-126 - Investigation between OS and clinical and laboratory findings at the time of administering chemotherapy in ED-SCLC

Introduction: Survival of extensive disease small-cell lung cancer (ED-SCLC) is generally poor.Some clinical trials performed in several countries showed that overall survival (OS) of ED-SCLC was from about nine to twelve months.The relation between some clinical nor laboratory findings at starting chemotherapy and OS has not been proved yet. Aims and Methods: We intended to reveal whether the clinical or laboratory findings at the time of starting systemic chemotherapy would affect OS of ED-SCLC.We retrospectively checked medical records of 96 ED-SCLC patients, who received systemic chemotherapy in our institution from January 2007 to December 2015. Background: We classified the clinical and laboratory findings of the ED-SCLC patients before administrating systemic chemotherapy as follows:ages less than 70 years or over, sex, good PS (0-1) or poor PS (2-4), elevation of tumor markers (Pro-GRP and NSE) and LDH above their standard values, presence of pleural effusion, distant metastasis in brain, liver or bone. Result: Median OS from the first day of chemotherapy, analyzed at January 2016, was 259 days (95% confidence interval 222-313).The univariate analysis by logrank-test showed that statistical difference in shorter OS was observed in elder ages, poor PS, existence of bone or liver metastasis, and elevation of LDH. In a multivariate analysis these five selected variables, the factors significantly associated with shorter OS were poor PS (p<0.0001, HR3.81,95% C.I. 2.12-6.85), existence of bone metastasis (p<0.05, HR1.71, 95% C.I. 1.10-2.66) and liver metastasis (p<0.005, HR2.22, 95% C.I. 1.35-3.64). Conclusion: Poor PS, bone and liver metastasis were demonstrated to be the independent poor prognostic factors.We also concluded that brain metastasis did not play as a poor prognostic factor because most cases with brain metastasis received whole brain radiation therapy, and some cases with bone metastasis might improve their survival by receiving palliative radiation therapy.

Circulating concentrations of interleukin-6 in cancer patients and their pathogenic role in tumor-induced hypercalcemia.

Circulating interleukin-6 (IL-6) concentrations correlate with disease activity in severe inflammatory conditions, in sepsis and in some hematological malignancies. On the other hand, IL-6 is a potent stimulator of osteoclastogenesis and has been implicated as a contributory factor in the genesis of osteopenic conditions. We measured circulating IL-6 levels by a sensitive (detection limit of 10 U/ml) and specific bioassay in 103 patients with advanced cancer, including 41 with tumor-induced hypercalcemia before any specific hypocalcemic therapy. We related IL-6 concentrations to clinical features and to biochemical parameters of bone metabolism, including blood Ca, Ca2+, Pi, intact parathyroid hormone, parathyroid hormone-related protein, osteocalcin, 1,25-(OH)2-vitamin D and, as markers of bone resorption, the fasting urinary excretion of calcium (Ca/creatinine) and hydroxyproline. IL-6 levels were increased, i.e. detectable, in 23% of the patients, 8/41 (20%) hypercalcemic and 16/62 (26%) normocalcemic patients (NS); the distribution of the values was similar in the two groups. The presence of increased IL-6 concentrations was not related to any clinical characteristic, notably not to the survival nor to the existence of bone metastases, whether in hypercalcemic or normocalcemic patients; e.g., only 3/12 (25%) hypercalcemic subjects without bone metastases had elevated IL-6 levels. We found no significant correlations between IL-6 concentrations and any of the biochemical parameters studied. Hypercalcemic subjects with increased IL-6 had higher urinary Ca/creatinine levels than patients with normal IL-6 levels (P < 0.005) but this was not the case in normocalcemic subjects. Mean concentrations of inflammatory or other bone metabolism markers were not significantly different between patients with normal or with elevated IL-6 levels. In summary, circulating IL-6 levels were increased in 23% of 103 patients with advanced cancer, but the frequency of increased IL-6 concentrations was not related to the presence of hypercalcemia or to any marker of calcium metabolism or bone turnover. The pathogenic importance of circulating IL-6 in patients with solid tumors remains to be demonstrated and our data indicate that increased circulating levels of IL-6, possibly reflecting the activation of the immune system, only contribute in a minor way to the osteolytic process in patients with tumor-induced hypercalcemia.

Carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and other prognostic indicators in squamous cell lung cancer

Multivariate models of survival have been established for both small cell and non-small cell lung cancers. So far, no study has focussed on squamous cell types. Previous demonstrations of the prognostic value of the tissue polypeptide antigen (TPA) and, partially, of the carcinoembryonic antigen (CEA) are based on univariate analyses of survival. These analyses do not account for the other prognostic factors. In the present study, we report the combined influence of various clinical and biological characteristics on the survival duration of 360 patients with a newly diagnosed squamous cell carcinoma of the lung. The study comprised 29 variables, including age, sex, smoking habit (SH), symptoms at diagnosis, the Karnofsky performance status (KPS), weight loss (WL), radiological findings, various disease extent parameters (DEP), CEA and TPA. Preliminary univariate analyses showed that 20 variables were survival-related. The Cox proportional hazards regression analysis selected stage of disease, KPS, TPA, WL, the existence of bone metastases, and SH as independent factors of prognosis (global chi-square: 122.40, P = 0.0000). A second multivariate analysis, performed with the same covariates but excluding DEP, revealed previous pulmonary diseases and CEA to be in addition to KPS, TPA, SH, and WL the next most influential prognostic determinants. Also in squamous cell lung cancer, classifications based on the Cox's prediction equation may improve individual counseling and patient selection for therapeutic trials. In this malignancy, TPA shows an independent and strong prognostic significance while CEA shares informations of diverse other prognostic factors and seems to be less important.