Prospective study of bone scintigraphy as a staging investigation for oesophageal carcinoma

Jennings, N; Griffin, S. M.; Lamb, PJ; Preston, Shaun R.; Richardson, Diane; Karat, D; Hayes, Nick

doi:10.1002/bjs.6175

Cited by 4 publications

(14 citation statements)

References 25 publications

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“…Au Japon, dans une série de 44 patients présentant un cancer de l’œsophage, 2 cas de métastases costales ont été rapportés; tandis que dans la série de Jennings, 11 cas de métastases costales ont été répertoriés sur 719 cancers œsophagiens colligés [3, 4]. …”

Section: Discussionunclassified

Métastase costale révélant un carcinome épidermoïde de l’œsophage

et al. 2017

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Le cancer de l'œsophage est une tumeur de mauvais pronostic. Sa gravité est liée au retard de diagnostic qui se fait le plus souvent au stade de métastase en Afrique. Les métastases costales de ce cancer sont rares. Nous rapportons un cas de carcinome épidermoïde du bas œsophage avec métastases costales lytiques chez une patiente sénégalaise de 38 ans. Il s’agissait de madame TD, âgée de 38 ans admise pour une tuméfaction douloureuse de l’hémithorax droit dans un contexte d’amaigrissement. La patiente signalait par ailleurs une dysphagie d’allure mécanique évoluant depuis 4 mois qui n’avait pas motivé de consultation. L’examen objectivait un mauvais état général, une tuméfaction dure, sensible mesurant 3 cm de grand axe, siégeant sur la face antérolatérale de l’hémithorax droit en regard de la 5ème côte. Les examens biologiques mettaient en évidence une anémie normochrome normocytaire avec un taux d’hémoglobine à 9,4 g/dl, un syndrome inflammatoire biologique non spécifique et une hypercalcémie (calcémie corrigée= 107 mg/l). L’endoscopie oeso-gastroduodénale objectivait une lésion ulcéro bourgeonnante sténosante à 32 cm des arcades dentaires. L’examen anatomopathologique des biopsies mettait en évidence un carcinome épidermoïde moyennement différencié. La tomodensitométrie thoraco-abdomino pelvienne montrait en plus de la tumeur œsophagienne, une lyse osseuse de l’arc antérieure de la 5ème côte, des nodules pulmonaires carcinomateuses et un épanchement pleural bilatéral. La ponction exploratrice du liquide pleural ramenait un liquide sérohématique et l’examen cytologique de ce liquide objectivait des cellules carcinomateuses. Le diagnostic de carcinome épidermoïde du bas œsophage avec métastases costales, pleurales et pulmonaires était retenu et un traitement palliatif instauré. L’évolution était marquée par le décès de la patiente survenu 3 mois après la réalisation de la gastrostomie, dans un tableau de détresse respiratoire. L’originalité de cette observation tient au siège atypique des métastases de ce cancer de l’œsophage; mais aussi le terrain de survenue de cette tumeur. Le cancer de l’œsophage du sujet jeune est un problème majeur en Afrique. Le challenge est de déterminer ses facteurs de risque afin de prévenir sa survenue.

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Section: Discussionunclassified

Métastase costale révélant un carcinome épidermoïde de l’œsophage

et al. 2017

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“…a radiografia mostra frequentemente lesões ósseas osteolíticas 7 . o padrão atual de prática para a detecção de doenças metastáticas é cintilografia óssea convencional de todo o corpo usando o tecnécio -99 m metileno difosfonato (tc-99m MdP) 11 . a tomografia por emissão de pósitrons (Pet), com 18-F-fluorodeoxyglucose (Pet-FdG), mostra em estudo, na detecção de metástases ósseas, 92 % de sensibilidade, especificidade de 94% e acurácia de 93%, em comparação com 77%, 84% e 82%, respectivamente, para cintilografia óssea 5 .…”

Section: Discussionunclassified

Acrometástase de Carcinoma de Células Escamosas do Esôfago: Relato de Caso

Dias¹,

Figueiredo²,

Monção

et al. 2014

Rev. Brasileira.De.Cancerologia

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Introdução: Neoplasias metastáticas para as mãos são raras, representando aproximadamente 0,1 % de todo o envolvimento ósseo metastático e mais excepcionalmente de tumores gastrointestinais, como o carcinoma de esôfago. Objetivo: Relatar um caso atípico de neoplasia de esôfago de células escamosas com acrometástase para mão. Relato de caso: Homem, 48 anos, com quadro clínico de disfagia progressiva. Submetido a endoscopia digestiva alta que revelou lesão ulcerada de bordas elevadas, medindo aproximadamente 12 mm no seu maior diâmetro, com biópsia, que confirmou carcinoma de células escamosas pouco diferenciado e invasor, Grau III. Realizada esofagectomia após quimioterapia e radioterapia neoadjuvante. Após dois anos do procedimento cirúrgico, paciente evolui com edema, eritema leve e dor local em punho e mão esquerda, restringindo movimentos dos primeiro e terceiro quirodáctilos. Radiografia com extensas lesões osteolíticas, cintilografia óssea com atividade óssea aumentada. Biópsia local confirmou carcinoma de células escamosas metastático em partes moles, de foco primário do esôfago. Conclusão: Metástase óssea de extremidade no carcinoma de esôfago e rara. Com aumento da longevidade dos pacientes oncológicos, novas propedêuticas devem ser discutidas na detecção precoce das metástases ósseas.

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“…For patients receiving esophagectomy, the bone metastasis events were recorded until death or the last follow-up. Bone recurrence was defined as bone metastasis detected as the first site of recurrence after esophagectomy or detected within 1 month of first site of recurrence after esophagectomy [ 7 , 13 ]. For patients who did not receive esophagectomy, the bone metastasis events were recorded within 6 months of initial bone scan.…”

Section: Methodsmentioning

confidence: 99%

“…Quint et al [ 12 ] suggested that routine preoperative bone scan identifies metastases only in the presence of widespread metastatic or unresectable locoregional disease within the abdomen and thorax. Nevertheless, Jennings et al [ 13 ] reported that skeletal system is frequently the first site of identifiable distant metastatic spread, and bone scan is recommended to exclude metastatic diseases before radical treatment of esophageal cancer. Most importantly, the majority of esophageal cancers in previous studies evaluating the role of bone scan [ 4 , 12 , 13 ] are esophageal adenocarcinoma, not esophageal squamous cell carcinoma.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, Jennings et al [ 13 ] reported that skeletal system is frequently the first site of identifiable distant metastatic spread, and bone scan is recommended to exclude metastatic diseases before radical treatment of esophageal cancer. Most importantly, the majority of esophageal cancers in previous studies evaluating the role of bone scan [ 4 , 12 , 13 ] are esophageal adenocarcinoma, not esophageal squamous cell carcinoma. Gockel et al [ 14 ] reported that these two histologic tumor types in esophageal cancer exhibit different behavior, and squamous cell carcinoma shows an earlier lymphatic spread and a worse prognosis compared to adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

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Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma

Huang

et al. 2012

BMC Cancer

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BackgroundCorrect detection of bone metastases in patients with esophageal squamous cell carcinoma is pivotal for prognosis and selection of an appropriate treatment regimen. Whole-body bone scan for staging is not routinely recommended in patients with esophageal squamous cell carcinoma. The aim of this study was to investigate the role of bone scan in detecting bone metastases in patients with esophageal squamous cell carcinoma.MethodsWe retrospectively evaluated the radiographic and scintigraphic images of 360 esophageal squamous cell carcinoma patients between 1999 and 2008. Of these 360 patients, 288 patients received bone scan during pretreatment staging, and sensitivity, specificity, positive predictive value, and negative predictive value of bone scan were determined. Of these 360 patients, surgery was performed in 161 patients including 119 patients with preoperative bone scan and 42 patients without preoperative bone scan. Among these 161 patients receiving surgery, 133 patients had stages II + III disease, including 99 patients with preoperative bone scan and 34 patients without preoperative bone scan. Bone recurrence-free survival and overall survival were compared in all 161 patients and 133 stages II + III patients, respectively.ResultsThe diagnostic performance for bone metastasis was as follows: sensitivity, 80%; specificity, 90.1%; positive predictive value, 43.5%; and negative predictive value, 97.9%. In all 161 patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P = 0.009, univariately). In multivariate comparison, absence of preoperative bone scan (P = 0.012, odds ratio: 5.053) represented the independent adverse prognosticator for bone recurrence-free survival. In 133 stages II + III patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P = 0.003, univariately) and overall survival (P = 0.037, univariately). In multivariate comparison, absence of preoperative bone scan was independently associated with inferior bone recurrence-free survival (P = 0.009, odds ratio: 5.832) and overall survival (P = 0.029, odds ratio: 1.603).ConclusionsAbsence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival, suggesting that whole-body bone scan should be performed before esophagectomy in patients with esophageal squamous cell carcinoma, especially in patients with advanced stages.

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Prospective study of bone scintigraphy as a staging investigation for oesophageal carcinoma

Abstract: Bone is frequently the first site of identifiable distant metastatic spread, and bone scintigraphy is recommended to exclude metastatic disease before radical treatment of advanced oesophageal carcinoma.

Cited by 4 publications

References 25 publications

Métastase costale révélant un carcinome épidermoïde de l’œsophage

Métastase costale révélant un carcinome épidermoïde de l’œsophage

Acrometástase de Carcinoma de Células Escamosas do Esôfago: Relato de Caso

Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma

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