Skeletal Metastasis of Unknown Primary Origin at the Initial Visit: A Retrospective Analysis of 286 Cases.
Skeletal Metastasis of Unknown Primary Origin at the Initial Visit: A Retrospective Analysis of 286 Cases.
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DOI：
10.1371/journal.pone.0129428
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Saito T
中科院分区：
文献类型：
--
作者：
Takagi T;Katagiri H;Kim Y;Suehara Y;Kubota D;Akaike K;Ishii M;Mukaihara K;Okubo T;Murata H;Takahashi M;Kaneko K;Saito T
骨转移是多种癌症的常见转移事件，原发灶不明骨转移（SMUP）的治疗是癌症治疗中的关键问题。对原发部位进行诊断是 SMUP 治疗中最关键的一步；然而，这些程序有时既困难又耗时，而且主要地点往往仍然未知。因此，为了建立最佳的诊断策略并阐明 SMUP 的总体生存率，我们进行了这项回顾性研究。我们回顾性分析了 286 例 SMUP 病例的临床数据，这些患者来自 2002 年至 2014 年期间接受治疗的 2,641 名骨转移患者。在 254/286 名患者 (88.8%) 中确定了原发部位，而我们的诊断策略未检测到 32 名 (11.2%) 原发部位。 72 例 (25.2%) 病例中发现肺癌，是最常见的原发性病变。 SMUP患者的中位生存时间为20.0个月，单发骨转移和多发骨转移病例的中位生存时间分别为39.0个月和16.0个月。前列腺癌患者的中位生存时间超过120个月，原发性肺癌患者的中位生存时间为9.0个月，最终诊断为原发灶不明的患者的中位生存时间为11.0个月。我们相信，我们的研究将有助于建立诊断 SMUP 患者原发部位的最佳策略，并且我们的数据为不同 SMUP 情况的生存时间提供了明确的指示。
Skeletal metastasis is a common metastatic event for several carcinomas, and the treatment for skeletal metastasis of unknown primary (SMUP) are a critical issue in cancer therapy. Making a diagnosis of the primary site is the most crucial step in the treatment of SMUP; however, the procedures are sometimes difficult and time-consuming, and the primary site often remains unknown. Therefore, to establish optimal diagnostic strategies and elucidate the overall survival rates of SMUP, we conducted this retrospective study. We retrospectively analyzed the clinical data for 286 SMUP cases from a total of 2,641 patients with skeletal metastases who were treated between 2002 and 2014 at our initiations. The primary sites were identified in 254/286 patients (88.8%), while 32 (11.2%) primary sites were not detected by our diagnostic strategies. Lung cancer was identified in 72 (25.2%) cases, and was the most frequently observed primary lesion. The median survival time of the SMUP patients was 20.0 months, while the median survival times of solitary bone metastasis cases and multi-bone metastasis cases were 39.0 months and 16.0 months, respectively. The median survival times of prostate cancer cases was over 120 months, that of patients with primary lung cancers was 9.0 months and the median survival time of cases who were finally diagnosed with an unknown primary was 11.0 months. We believe that our study would contribute to establishing an optimal strategy for diagnosing the primary site in SMUP patients, and our data provide definite indications for the survival times for different SMUP situations.
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