P-0062 - Clinical Investigation of the Bone Metastasis from Digestive Cancer
|Date||28 June 2014|
|Event||World GI 2014|
|Topics|| Gastrointestinal Cancers
|Citation||Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165|
The bone metastasis of the malignant tumor is often seen by breast cancer, lung cancer, prostate cancer, a renal cell carcinoma and causes a skeletal related event (SRE) called the sharp pain of the bone metastasis part, the secondary fracture, and the neuropathy by the spinal cord pressure and QOL is spoiled remarkably, not only it is said with the metastasis of one simple organ, but also is important clinically. As a result of having examined the case that I experienced about the bone metastasis of digestive cancer in our hospital, I report some knowledge that I was able to get.
All of the 89 cases being considered are those that was diagnosed as being bone metastasis of digestive cancer in CT, MRI, bone scintigraphy in our hospital during a period from January, 2006 to June, 2011, and that were confirmed dead, and I examined it statistically.
Among all 89 cases, 57 men, women 32, age median 66 years old, primary lesion were 41 stomach cancer, liver cancer 22, esophageal cancer 9, pancreatic cancer 8, colon cancer 5, biliary tract cancer 4, the treated cases were 69, the chemotherapy cases were 57. The median of the serum ALP level was 518 (104-40890) IU/L, and 64 cases (71.9%) exceeded the standard value. The median of the serum LDH level was 238(91-3284)IU/L. The median survival time in all 89 cases was 133 days, and the prognosis was poor. The factor which prescribed prognosis was the treatment (P < 0.001), chemotherapy (P = 0.002), serum LDH high price (P = 0.006). In 66 cases that were able to chase a serum ALP level since diagnostic imaging more than two months, it was good-prognosis (P = 0.018) that the cases that a serum ALP level two months after the diagnosis decrease in comparison with a diagnosis (ALP ratio = post 2M ALP/pre ALP). ALP ratio and a serum LDH high price were chosen for the multivariate analysis (P = 0.004). In 41 cases of stomach cancer most in primary lesion, there was not the significant difference, but the case taken the zoledronic acid accepted the tendency that had a good prognosis (P = 0.056).
If a case that serum ALP level is a high price or a case that has a clinical symptom but serum ALP level is the standard value, it is important that you doubt bone metastasis and perform an examination for image. It had a good prognosis in the case that a serum ALP level two months after the diagnosis decreased by aggressive treatment including the chemotherapy, and it was thought that the change of the serum ALP level reflected the condition of a patient. In addition, the possibility with the prognostic improvement effect was thought about for a bone metastasis patient by an antitumor effect of the zoledronic acid.