Natural history of malignant bone disease in renal cancer: final results of an Italian bone metastasis survey.
Natural history of malignant bone disease in renal cancer: final results of an Italian bone metastasis survey.
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DOI：
10.1371/journal.pone.0083026
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Bracarda S
中科院分区：
文献类型：
--
作者：
Santini D;Procopio G;Porta C;Ibrahim T;Barni S;Mazzara C;Fontana A;Berruti A;Berardi R;Vincenzi B;Ortega C;Ottaviani D;Carteni G;Lanzetta G;Virzì V;Santoni M;Silvestris N;Satolli MA;Collovà E;Russo A;Badalamenti G;Fedeli SL;Tanca FM;Adamo V;Maiello E;Sabbatini R;Felici A;Cinieri S;Tonini G;Bracarda S
随着疾病相关生存率的提高，骨转移是晚期肾细胞癌（RCC）日益严重的临床问题。关于肾细胞癌骨疾病自然史的数据很少。对398例有骨转移证据的死亡RCC患者（286例男性，112例女性）的临床病理学、生存率、肿瘤相关事件（SRE）和骨导向治疗的数据进行统计学分析。对于诊断时无骨转移的患者，中位骨转移时间为25个月。根据MSKCC风险诊断骨转移的中位时间为24个月，中度风险为5个月，低风险为0个月。SRE/患者的中位数为1例，71%的患者至少发生1例SRE。第一次、第二次和第三次SRE的中位时间分别为2、5和12个月。骨转移诊断后的中位生存期为12个月，首次SRE后为10个月。在181例接受唑来膦酸治疗的患者中，首次SRE的中位时间与对照组（n = 186）相比显著延长（3个月vs对照组1个月; P<0.05）。 伴有骨转移的RCC患者持续面临SRE的风险，在这项调查中，ZOL有效地降低了这种风险。
Bone metastasis represents an increasing clinical problem in advanced renal cell carcinoma (RCC) as disease-related survival improves. There are few data on the natural history of bone disease in RCC. Data on clinicopathology, survival, skeletal-related events (SREs), and bone-directed therapies for 398 deceased RCC patients (286 male, 112 female) with evidence of bone metastasis were statistically analyzed. Median time to bone metastasis was 25 months for patients without bone metastasis at diagnosis. Median time to diagnosis of bone metastasis by MSKCC risk was 24 months for good, 5 months for intermediate, and 0 months for poor risk. Median number of SREs/patient was one, and 71% of patients experienced at least one SRE. Median times to first, second, and third SRE were 2, 5, and 12 months, respectively. Median survival was 12 months after bone metastasis diagnosis and 10 months after first SRE. Among 181 patients who received zoledronic acid (ZOL), median time to first SRE was significantly prolonged versus control (n = 186) (3 months vs 1 month for control; P<0.05). RCC patients with bone metastasis are at continuous risk of SREs, and in this survey ZOL effectively reduced this risk.
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