Pathologic fracture and metastatic spinal cord compression in patients with prostate cancer and bone metastases

BMC Urology

Research Article

Adam Pawinski¹  Ellinor Haukland¹  Astrid Dalhaug¹  Carsten Nieder² 

[1] Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway;Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway;Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway;

关键词: Prostate Cancer;    Bone Metastasis;    Zoledronic Acid;    Pathologic Facture;    Taxotere;   

DOI  :  10.1186/1471-2490-10-23

 received in 2009-12-02, accepted in 2010-12-22,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study was to determine the risk factors for and incidence as well as prognostic impact of pathologic fracture (PF) and metastatic spinal cord compression (MSCC) in patients with bone metastases (BM) from prostate cancer.MethodsRetrospective cohort study including 61 consecutive patients seen at Nordland hospital's department of oncology between 2007 and 2009. The initial diagnosis of BM might have been made earlier. Twenty-nine patients (48%) received taxotere and 72% zoledronic acid after diagnosis of BM.ResultsMedian actuarial survival after diagnosis of BM was 23 months. Six patients (10%) were alive at 5 years. Bone pain at baseline was present in 49% of patients. Eighty-nine percent required external beam radiotherapy and/or radioisotopes after diagnosis of BM. Seventeen patients (28%) developed at least one major skeletal complication, i.e. MSCC or PF (4 of them developed more than one). The actuarial risk was 44% at 4 and 5 years. Most events developed before treatment with zoledronic acid and/or taxotere. Median survival from diagnosis of either MSCC or PF was 11 months (5 months from MSCC). We did not identify statistically significant risk factors for development of major skeletal complications. Serum alkaline phosphatase above median value and age less than or equal to 70 years were the only risk factors approaching significance.ConclusionsWe found high rates of major skeletal complications in this unselected contemporary group of patients. Identification of risk factors might guide the development of early interventions aiming at prevention of MSCC and PF.

【 授权许可】

CC BY   
© Nieder et al; licensee BioMed Central Ltd. 2010