A Scoring System to Predict the Development of Bone Metastasis After Radical Resection of Colorectal Cancer

Li, Ang; Käsmann, Lukas; Rades, Dirk; Fu, Chuangang

doi:10.21873/anticanres.11938

Cited by 12 publications

(21 citation statements)

References 13 publications

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“…Thus, patients with lung metastases and high CEA should be monitored for BM especially for CEA values exceeding >100 μg/L. Our results (showed in Table 3 )were similar to the literature reported by Li A, et al [19] . They found three independent risk factors, namely rectal cancer, lymph node metastasis (LN) and pulmonary metastasis (PM) for developing a scoring system to predict bone metastasis after radical resection within 5 years.…”

Section: Discussionsupporting

confidence: 91%

Retrospective study of predictors of bone metastasis in colorectal cancer patients

Zhenghong

Zhu

Guoweijian

et al. 2017

Journal of Bone Oncology

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BackgroundWe explored risk factors for bone metastasis (BMs) in colorectal cancer (CRC) to improve in early diagnosis and follow-up and to reduce bone metastasis.MethodsWith a retrospective analysis of 2066 patients with CRC treated in our institution from January 2006 to January 2015, we assessed high-risk variables associated with bone metastasis using univariate and multivariate analyses.ResultsOf those subjects studied, 102 patients developed BMs, including 62 of 1014 the rectal cancer patients and 40 of the 1052 colon cancer patients. Lung metastases were accounting for 59.8% of the BMs (χ2 = 17.7, p<0.01) and hepatic metastases were accounting for 34.3% of BMs (χ2 = 3.06,p >0.05). BMs were diagnosed more rapidly in the presence of lung metastases(6.9 months versus 11.6 months for liver metastases). Univariate analysis revealed that BMs were associated with primary tumor location (p < 0.001), lung metastases (p < 0.001), initial stage (p = 0.001), radiotherapy (p < 0.001) and serum carcinoembryonic antigen (CEA) (p=0.001). Multivariate analysis revealed that primary tumor location (rectum), lung metastases, and serum CEA (>5 μg/L) were statistically significant (p <0.05).ConclusionsBMs in rectal cancer occur more frequently than in colon cancer. Lung metastases predicted potential progression to bone in CRCs more than liver metastases. Primary rectal locations, lung metastases and serum CEA were independent risk factors for BMs in CRC. Thus, patients should receive early bones scanning when presenting with CRC.

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Section: Discussionsupporting

confidence: 91%

Retrospective study of predictors of bone metastasis in colorectal cancer patients

Zhenghong

Zhu

Guoweijian

et al. 2017

Journal of Bone Oncology

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“…In previous studies, the tumor location was detected to be an independent risk factor for predicting BM in CRC. [ 4 , 17 ] But this result was not confirmed in our study.…”

Section: Discussioncontrasting

confidence: 82%

The risk factors for bone metastases in patients with colorectal cancer

Cao

Liu

et al. 2018

Medicine

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This retrospective analysis aim to evaluate the potential risk factors for bone metastases (BM) in patients who were diagnosed with colorectal cancer (CRC).A total of 2790 patients diagnosed with CRC between January 2006 and December 2016 were collected in this study. All patients were divided into 2 groups, BM and no BM. The associations between biomarkers (including age, gender, histopathological types, alkaline phosphatase (ALP), carcinoembryonic antigen (CEA), cancer antigen 125, and so on), and BM in patients with CRC were analyzed. All the analyses were conducted by SPSS software (version 22.0, SPSS, Chicago, IL).Of all patients, 74 (2.7%) were identified with BM. The level of serum ALP, CEA, and cancer antigen 125 in patients with BM were obviously higher than those without BM (P < .001, P = .005, and P < .001). And the cut-off values of ALP, CEA, and cancer antigen 125 were 85.5 U/L, 6.9 mmol/L, and 16.8 mmol/L, respectively.ALP, CEA, and cancer antigen 125 were identified as the independent risk factors for BM in patients with CRC.

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“…Six studies included unselected cohorts of patients with CRC [12], [15], [33], [34]. The remaining studies included various cohorts of patients, for example cohorts only including patients with mCRC, CRC patients who underwent surgery, patients with adenocarcinoma or only rectal cancer patients [16], [32], [35], [36], [37], [38], [39], [40]. Furthermore, most studies did not report the exact follow-up period and those that did had different follow-up periods.…”

Section: Resultsmentioning

confidence: 99%

“…CRCNo. BMIncidence of BM (%)95% CI (%)Survival after BM diagnosisFollow up Retrospective studies All cases diagnosed with CRCSantini et al2012Italy [12]1985-2009All cases with CRC>2500264∼109.4 - 11.8Median 7 monthsNR – all dead at last follow upPortales et al2015France [13]1996-2006All cases with CRC24341104.53.7 – 5.4Median 9.4 months-Bonnheim et al1986USA [14]1970-1980All cases with CRC1406664.73.6 - 5.9Median 7 months-Zhenghong et al 2017China [15]2006-2015All cases with CRC20661024.94.0 – 6.0--Selected patients with CRCLi et al 2017China [16]Underwent radical surgery. T any N any M 0 1749502.92.2 - 3.8-5 yearsBaek et al2016South Korea [17]2007-2013Underwent surgery(including surgery for stage 4)5479631.20.9 - 1.5Median: 17.8Mean 19.6 monthsLan et al 2015 Taiwan [18]2000-2010Underwent surgery (including surgery for stage 4)149220a1.30.9 - 0.21-Median 69.7 monthsSun et al2015China [19]2004-2009Underwent radical surgery (including surgery for stage 4)AdenocarcinomaNo BM at primary surgery516316.04.1 - 8.4-Median 69.5 monthsJimi et al2013Japan [20]1993-2008Underwent surgery(including surgery for stage 4)…”

Section: Resultsmentioning

confidence: 99%

Systematic review: Incidence, risk factors, survival and treatment of bone metastases from colorectal cancer

Christensen

Jensen

Larsen

et al. 2018

Journal of Bone Oncology

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BackgroundBones are not considered a frequent metastatic site in patients with colorectal cancer (CRC). The purpose of the present study was to determine the incidence of bone metastases (BM) in CRC, to identify possible risk factors for BM, survival after BM, and effect of treatment of BM including antiresorptive treatment.Material and methodsA computer-based literature search was carried out using PubMed and EMBASE.ResultsWe included 29 studies. One randomized placebo controlled trial (RCT) study, two autopsy studies, five register studies, and twenty retrospective cohort studies. The studies described different cohorts making direct comparison difficult. Three studies analysed the effect of different treatments for BM including one RCT study.ConclusionThe incidence of bone metastases was 3–7% in patients with CRC, and it was not possible to detect an increase in incidence over time. The most well established risk factors for BM are rectal cancer, having lymph node invasion at surgery of primary tumor, and lung metastases at any time. Other risk factors such as RAS mutation status have been suggested but results are not conclusive. Survival ranges from 5 to 21 months after diagnosis of BM depending on cohort, with survival of about 8 months in unselected patients. Several variables have been suggested as potential prognostic markers but are all poorly investigated. Treatment of BM is not well investigated, though patients seem to benefit from bisphosphonate treatment with regard to lower risk of skeletal related events. This review highlights the need for new research in the area.

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A Scoring System to Predict the Development of Bone Metastasis After Radical Resection of Colorectal Cancer

Abstract: This new score can help clinicians identify patients at risk for continuous monitoring and optimize surveillance to be able to detect and treat bone metastases very early in order to avoid skeletal complications.

Cited by 12 publications

References 13 publications

Retrospective study of predictors of bone metastasis in colorectal cancer patients

Retrospective study of predictors of bone metastasis in colorectal cancer patients

The risk factors for bone metastases in patients with colorectal cancer

Systematic review: Incidence, risk factors, survival and treatment of bone metastases from colorectal cancer

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