Araştırma Makalesi
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Review of upper extremity bone metastasis: A retrospective cohort study of 61 patients

Yıl 2020, Cilt: 4 Sayı: 12, 1223 - 1226, 01.12.2020

Koray Başdelioğlu

https://doi.org/10.28982/josam.823584

Öz

Aim: Although bone metastasis is the most common bone cancer in adults, its spread to the upper extremity is relatively low. Distribution characteristics of upper extremity bone metastases are not clearly defined. In this study, we aimed to investigate upper extremity metastases, reveal the distribution of upper extremity metastases compared to primary cancers, and evaluate their relationship with additional bone metastases and additional visceral organ metastases.
Methods: Sixty-one patients diagnosed with upper extremity metastasis between 2018-2020 were included in the study and analyzed retrospectively. Clinical data, pathology, PET-CT and MRI reports were evaluated. Demographic characteristics (age, gender), primary cancer type, metastasis location (scapula, clavicle, humerus (proximal, diaphysis, distal) and forearm (proximal, diaphysis and distal)), number of metastases (single / multiple foci), additional bone and visceral organ metastases were evaluated.
Results: Thirteen (52.00%) female and 22 (61.11%) male patients had multiple upper extremity metastases (P=0.657). The most common location of metastasis was proximal humerus for both genders. Proximal humerus was the most common metastasis location in breast (58.82%), lung (55.56%) and prostate (87.50%) cancers. Scapula was the most common metastasis location in gastrointestinal (87.50%) and urinary tract (83.33%) cancers. Scapula and proximal humerus were the most common metastasis locations in gynecologic (66.67%) cancers. The most common accompanying bone metastasis site was the vertebra for both genders. The most common visceral organ metastasis was the lung (20.00%) in females and liver (16.67%) in males.
Conclusion: The most common location of metastases in the upper extremity is the proximal humerus, followed by the scapula. The incidence of upper extremity metastasis decreases from proximal to distal. Solving this mechanism may be beneficial for treatment and survival.

Anahtar Kelimeler

Upper extremity Bone metastases Primary cancer

Kaynakça

  • 1. Dijkstra S, Stapert J, Boxma H, Wiggers T. Treatment of pathological fractures of the humeral shaft due to bone metastases: a comparison of intramedullary locking nail and plate osteosynthesis with adjunctive bone cement. Eur J Surg Oncol. 1996;22:621-6.
  • 2. Frassica FJ, Frassica DA. Evaluation and treatment of metastases to the humerus. Clin Orthop Relat Res. 2003:S212-8. doi:10.1097/01.blo.0000093052.96273.a7
  • 3. Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev. 2001 Jun;27(3):165-76. doi: 10.1053/ctrv.2000.0210.
  • 4. Memon AG, Jaleel A, Aftab J. Patten of prostatic carcinoma metastases in bones detected by bone scans using Technitium 99m methyl dipohsphate (Tc99m MDP) imaging technique. Pak J Med Sci. 2006;22:180–3.
  • 5. Wisanuyotin T, Sirichatipavee W, Sumnanoont C, Paholpak P, Laupattarakasem P, Sukhonthamarn K, et al.. Prognostic and risk factors in patients with metastatic bone disease of an upper extremity. J Bone Oncol. 2018 Sep 22;13:71-5. doi: 10.1016/j.jbo.2018.09.007.
  • 6. Budczies J, Winterfeld MV, Klauschen F, Bockmayr M, Lennerz JK, Denkert J, et al. The landscape of metastatic progression patterns across major human cancers. Oncotarget. 2015 Jan 1;6(1):570-83. doi: 10.18632/oncotarget.2677.
  • 7. Kirkinis MN, Lyne CJ, Wilson MD, Choong PFM. Metastatic bone disease: A review of survival, prognostic factors and outcomes following surgical treatment of the appendicular skeleton. Eur J Surg Oncol. 2016 Dec;42(12):1787-97. doi: 10.1016/j.ejso.2016.03.036
  • 8. Kirkinis MN, Spelman T, May D, Choong PFM. Metastatic bone disease of the pelvis and extremities: rationalizing orthopaedic treatment. ANZ J Surg. 2017 Nov;87(11):940-4. doi: 10.1111/ans.13615
  • 9. Zhu M, Liu X, Qu Y, Hu S, Zhang Y, Li W, et al. Bone metastasis pattern of cancer patients with bone metastasis but no visceral metastasis. J Bone Oncol. 2019 Apr;15:100219. doi: 10.1016/j.jbo.2019.100219
  • 10. Rubens RD. Bone metastases – the clinical problem. Eur J Cancer. 1998;34:210–3. doi: 10.1016/s0959-8049(97)10128-9.
  • 11. Ratasvuori M, Wedin R, Keller J, Nottrott M, Zaikova O, Bergh P, et al. Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis. Surg Oncol. 2013 Jun;22(2):132-8. doi:10.1016/j.suronc.2013.02.008.
  • 12. Cai L, Dong S, Chen H. Olecranon metastases from primary lung cancer: case report and review of the literature. J Int Med Res. 2019 Oct;47(10):5312–7.
  • 13. Hasegawa S, Sakurai Y, Imazu H, Matsubara T, Ochiai M, Funabiki T, et al. Metastasis to the Forearm Skeletal Muscle from an Adenocarcinoma of the Colon: Report of a Case. Surg Today. 2000;30(12):1118-23.
  • 14. Wedin R, Hansen BH, Laitinen M, Trovik C, Zaikova O, Bergh P, et al. Complications and survival after surgical treatment of 214 metastatic lesions of the humerus. J Shoulder Elbow Surg. 2012 Aug;21(8):1049-55.
  • 15. Lahrach K, Chbani B, Amar F, Bennani A, Marzouki A, Boutayeb F. Humerus pathological fracture revealing biliary carcinoma. Orthop. Traumatol. Surg. Res. 2010;96(8):910-2.
  • 16. Dijkstra S, Stapert J, Boxma H, Wiggers T. Treatment of pathological fractures of the humeral shaft due to bone metastases: a comparison of intramedullary locking nail and plate osteosynthesis with adjunctive bone cement. Eur J Surg Oncol. 1996 Dec;22(6):621-6.
  • 17. Bıldırcın FD, Özdemir AZ, Karlı P, Çetinkaya MB. Breast cancer and ovulation induction. J Surg Med. 2019;3(8):612-8. doi: 10.28982/josam.605570
  • 18. Özmen S, Ceylan O. Trends in lung cancer incidence within the last 10 years: An Eastern Anatolian single center experience. J Surg Med. 2020;4(2):112-5.

Üst ekstremite kemik metastazlarının gözden geçirilmesi: 61 hastadan oluşan retrospektif kohort çalışma

Yıl 2020, Cilt: 4 Sayı: 12, 1223 - 1226, 01.12.2020

Koray Başdelioğlu

https://doi.org/10.28982/josam.823584

Öz

Amaç: Kemik metastazı yetişkinlerde en sık görülen kemik kanseri olmasına rağmen, üst ekstremiteye yayılımı nispeten azdır. Üst ekstremite kemik metastazlarının dağılım özellikleri açıkça tanımlanmamıştır. Bu çalışmada üst ekstremite metastazlarının araştırılması, üst ekstremite metastazlarının primer kanserler açısından dağılımının ortaya çıkarılması, ek kemik metastazları ve ek visseral organ metastazları ile ilişkisinin değerlendirilmesi amaçlanmıştır.
Yöntemler: 2018-2020 yılları arasında üst ekstremite metastazı tanısı olan 61 hasta çalışmaya dahil edildi ve retrospektif olarak incelendi. Klinik veriler, patoloji, PET-CT ve MRI raporları değerlendirildi. Demografik özellikler (yaş, cinsiyet), primer kanser tipi, metastaz lokalizasyonu (skapula, klavikula, humerus (proksimal, diafiz, distal) ve ön kol (proksimal, diafiz ve distal)), metastaz sayısı (tek/multiple odak), ek kemik ve viseral organ metastazları açısından hastalar değerlendirildi.
Bulgular: 13 kadın hastada (%52,00) multiple üst ekstremite metastazı varken 22 erkek hastada (%61,11) multiple üst ekstremite metastazı vardı (P=0,657). Metastazın en yaygın yeri her iki cinsiyet için proksimal humerustu. Proksimal humerus meme (%58,82), akciğer (%55,56) ve prostat (%87,50) kanserlerinde en sık metastaz bölgesiydi. Skapula, gastrointestinal sistem (%87,50) ve idrar yolu (%83,33) kanserlerinde en sık metastaz yeriydi. Jinekolojik kanserlerde (%66,67) en sık metastaz yerleri skapula ve proksimal humerustu. Eşlik eden en yaygın ek kemik metastaz alanı her iki cinsiyet için de vertebraydı. Kadınlarda en sık görülen viseral organ metastazı akciğer (%20,00), erkeklerde ise karaciğerde (%16,67) görüldü.
Sonuç: Üst ekstremite metastazlarının en sık yerleşim yeri proksimal humerustur ve bunu skapula izlemektedir. Üst ekstremite metastazının görülme insidansı proksimalden distale doğru azalmaktadır. Bu mekanizmanın çözülmesi tedavi ve sağ kalım için faydalı olabilir.

Anahtar Kelimeler

Üst ekstremite Kemik metastazı Primer kanser

Kaynakça

  • 1. Dijkstra S, Stapert J, Boxma H, Wiggers T. Treatment of pathological fractures of the humeral shaft due to bone metastases: a comparison of intramedullary locking nail and plate osteosynthesis with adjunctive bone cement. Eur J Surg Oncol. 1996;22:621-6.
  • 2. Frassica FJ, Frassica DA. Evaluation and treatment of metastases to the humerus. Clin Orthop Relat Res. 2003:S212-8. doi:10.1097/01.blo.0000093052.96273.a7
  • 3. Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev. 2001 Jun;27(3):165-76. doi: 10.1053/ctrv.2000.0210.
  • 4. Memon AG, Jaleel A, Aftab J. Patten of prostatic carcinoma metastases in bones detected by bone scans using Technitium 99m methyl dipohsphate (Tc99m MDP) imaging technique. Pak J Med Sci. 2006;22:180–3.
  • 5. Wisanuyotin T, Sirichatipavee W, Sumnanoont C, Paholpak P, Laupattarakasem P, Sukhonthamarn K, et al.. Prognostic and risk factors in patients with metastatic bone disease of an upper extremity. J Bone Oncol. 2018 Sep 22;13:71-5. doi: 10.1016/j.jbo.2018.09.007.
  • 6. Budczies J, Winterfeld MV, Klauschen F, Bockmayr M, Lennerz JK, Denkert J, et al. The landscape of metastatic progression patterns across major human cancers. Oncotarget. 2015 Jan 1;6(1):570-83. doi: 10.18632/oncotarget.2677.
  • 7. Kirkinis MN, Lyne CJ, Wilson MD, Choong PFM. Metastatic bone disease: A review of survival, prognostic factors and outcomes following surgical treatment of the appendicular skeleton. Eur J Surg Oncol. 2016 Dec;42(12):1787-97. doi: 10.1016/j.ejso.2016.03.036
  • 8. Kirkinis MN, Spelman T, May D, Choong PFM. Metastatic bone disease of the pelvis and extremities: rationalizing orthopaedic treatment. ANZ J Surg. 2017 Nov;87(11):940-4. doi: 10.1111/ans.13615
  • 9. Zhu M, Liu X, Qu Y, Hu S, Zhang Y, Li W, et al. Bone metastasis pattern of cancer patients with bone metastasis but no visceral metastasis. J Bone Oncol. 2019 Apr;15:100219. doi: 10.1016/j.jbo.2019.100219
  • 10. Rubens RD. Bone metastases – the clinical problem. Eur J Cancer. 1998;34:210–3. doi: 10.1016/s0959-8049(97)10128-9.
  • 11. Ratasvuori M, Wedin R, Keller J, Nottrott M, Zaikova O, Bergh P, et al. Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis. Surg Oncol. 2013 Jun;22(2):132-8. doi:10.1016/j.suronc.2013.02.008.
  • 12. Cai L, Dong S, Chen H. Olecranon metastases from primary lung cancer: case report and review of the literature. J Int Med Res. 2019 Oct;47(10):5312–7.
  • 13. Hasegawa S, Sakurai Y, Imazu H, Matsubara T, Ochiai M, Funabiki T, et al. Metastasis to the Forearm Skeletal Muscle from an Adenocarcinoma of the Colon: Report of a Case. Surg Today. 2000;30(12):1118-23.
  • 14. Wedin R, Hansen BH, Laitinen M, Trovik C, Zaikova O, Bergh P, et al. Complications and survival after surgical treatment of 214 metastatic lesions of the humerus. J Shoulder Elbow Surg. 2012 Aug;21(8):1049-55.
  • 15. Lahrach K, Chbani B, Amar F, Bennani A, Marzouki A, Boutayeb F. Humerus pathological fracture revealing biliary carcinoma. Orthop. Traumatol. Surg. Res. 2010;96(8):910-2.
  • 16. Dijkstra S, Stapert J, Boxma H, Wiggers T. Treatment of pathological fractures of the humeral shaft due to bone metastases: a comparison of intramedullary locking nail and plate osteosynthesis with adjunctive bone cement. Eur J Surg Oncol. 1996 Dec;22(6):621-6.
  • 17. Bıldırcın FD, Özdemir AZ, Karlı P, Çetinkaya MB. Breast cancer and ovulation induction. J Surg Med. 2019;3(8):612-8. doi: 10.28982/josam.605570
  • 18. Özmen S, Ceylan O. Trends in lung cancer incidence within the last 10 years: An Eastern Anatolian single center experience. J Surg Med. 2020;4(2):112-5.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi, Radyoloji ve Organ Görüntüleme, Onkoloji ve Karsinogenez
Bölüm Araştırma makalesi
Yazarlar

Koray Başdelioğlu 0000-0003-0235-4497

Yayımlanma Tarihi 1 Aralık 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 4 Sayı: 12

Kaynak Göster

APA Başdelioğlu, K. (2020). Review of upper extremity bone metastasis: A retrospective cohort study of 61 patients. Journal of Surgery and Medicine, 4(12), 1223-1226. https://doi.org/10.28982/josam.823584
AMA Başdelioğlu K. Review of upper extremity bone metastasis: A retrospective cohort study of 61 patients. J Surg Med. Aralık 2020;4(12):1223-1226. doi:10.28982/josam.823584
Chicago Başdelioğlu, Koray. “Review of Upper Extremity Bone Metastasis: A Retrospective Cohort Study of 61 Patients”. Journal of Surgery and Medicine 4, sy. 12 (Aralık 2020): 1223-26. https://doi.org/10.28982/josam.823584.
EndNote Başdelioğlu K (01 Aralık 2020) Review of upper extremity bone metastasis: A retrospective cohort study of 61 patients. Journal of Surgery and Medicine 4 12 1223–1226.
IEEE K. Başdelioğlu, “Review of upper extremity bone metastasis: A retrospective cohort study of 61 patients”, J Surg Med, c. 4, sy. 12, ss. 1223–1226, 2020, doi: 10.28982/josam.823584.
ISNAD Başdelioğlu, Koray. “Review of Upper Extremity Bone Metastasis: A Retrospective Cohort Study of 61 Patients”. Journal of Surgery and Medicine 4/12 (Aralık 2020), 1223-1226. https://doi.org/10.28982/josam.823584.
JAMA Başdelioğlu K. Review of upper extremity bone metastasis: A retrospective cohort study of 61 patients. J Surg Med. 2020;4:1223–1226.
MLA Başdelioğlu, Koray. “Review of Upper Extremity Bone Metastasis: A Retrospective Cohort Study of 61 Patients”. Journal of Surgery and Medicine, c. 4, sy. 12, 2020, ss. 1223-6, doi:10.28982/josam.823584.
Vancouver Başdelioğlu K. Review of upper extremity bone metastasis: A retrospective cohort study of 61 patients. J Surg Med. 2020;4(12):1223-6.
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