Clinical and Pathological Profiles of Vertebral Bone Metastases from Endometrial Cancers: Evidence from a Twenty-Year Case Series
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Patients’ Characteristics and Pathological Profiles
3.2. Bone Metastases
3.3. Surgical Approaches and Variables
3.4. Patients’ Survival Estimates
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient | Age—Years | BMI | Primary Tumor Histological Cell Types | Primary Tumor Histological Grade | Comorbidity | Smoking | Menopausal Status | Pre-Operative Hematological Parameters |
---|---|---|---|---|---|---|---|---|
1 | 69 | Not reported | Adenocarcinoma | G3 | Not reported | Not reported | Yes | Not reported |
2 | 66 | Not reported | Adenocarcinoma | G3 | Not reported | Not reported | Yes | Not reported |
3 | 73 | Not reported | Clear cell carcinoma | G3 | Not reported | Not reported | Yes | Not reported |
4 | 58 | Not reported | Adenocarcinoma | G3 | None | Not reported | Yes | Not reported |
5 | 31 | Not reported | Adenocarcinoma | G3 | None | No | Yes (surgically induced) | ↑ WBC; ↓ potassium, PLT, MPV |
6 | 53 | Not reported | Clear cell carcinoma | G3 | None | No | Yes | ↑ MCV, MCH; ↓ WBC |
7 | 75 | Not reported | Adenocarcinoma | G3 | Hypertension, gonarthrosis | No | Yes | ↑ LDH, WBC, Hb, fibrinogen |
8 | 46 | 36.7 | Clear cell carcinoma | G1 | Hashimoto’s thyroiditis | No | Yes | ↑ CRP, WBC, RDW, neutrophils; ↓ lymphocytes |
9 | 67 | 22.9 | Adenocarcinoma | G1 | Facioscapulohumeral muscular dystrophy, diabetes, hypertension, hypercholesterolemia | No | Yes | ↑ RDW, PLT, eosinophils, GGT; ↓ lymphocytes |
10 | 62 | 25.7 | Adenocarcinoma | G3 | Hypertension | Yes | Yes | ↑ ALP, GGT, CRP, neutrophils; ↓ RBCs, hematocrit, Hb, lymphocytes, PLT |
11 | 59 | 28.5 | Adenocarcinoma | G2 | Hypertension, hypercholesterolemia | No | Yes | ↓ RBCs, Hb, hematocrit, lymphocytes, CRP; ↑ eosinophils, ALP, GGT |
12 | 73 | 20.9 | Adenocarcinoma | G3 | CVI, renal insufficiency, diverticulosis, chronic multifactorial anemia | No | Yes | ↑ WBC, neutrophils, monocytes, CRP, GGT, fibrinogen; ↓ RBCs, Hb, hematocrit, lymphocytes |
13 | 56 | 18 | Clear cell carcinoma | G3 | None | Yes | Yes | ↓ RBCs, Hb, hematocrit, lymphocytes, eosinophils; ↑ neutrophils |
Patient | Bone Metastases Diagnosis | Time from Primary Diagnosis to Bone Metastasis (Months) | Main Bone Lesion Level | Other Bone Metastasis Lesions | Presence of Fracture | Extraosseous Metastases | Pain | Pre- and Post-Operative NRS (0–10) | Pre-Op Chemo-Radiotherapy | Frankel Pre-Op | Frankel Post-Op | Weinstein–Boriani–Biagini Classification | Post-Op Chemo-Radiotherapy | Frankel at Latest FU | Months to Dead/Last FU after Bone Metastasis, Status |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | PET, CT, bone biopsy | Not reported | L4 | No | No | Not reported | Yes | Not valuable | No | D2 | D3 | 3–11 A–D | No | E | 5, dead |
2 | PET, CT, bone biopsy | Not reported | L4 | No | Yes | Not reported | Yes | 4 1 | No | E | E | 2–8 A–E | Chemo-radiotherapy | E | 19, dead |
3 | PET, CT, bone biopsy | Not reported | L3 | Yes | No | No | Yes | Not valuable | No | E | E | 4–6 C–D | Radiotherapy | E | 26, alive with local disease control |
4 | PET, CT, bone biopsy | Not reported | L3 | Yes | Yes | Not reported | Yes | 5 1 | Radio-chemotherapy | C | D2 | 2–11 A–D | Chemo-radiotherapy | Unknown | Unknown |
5 | RX, MRI, CT | 12 months | T11 | Yes | No | No | Yes | 4 1 | Radiotherapy | E | E | 1–6 B–D | No | E | 81, alive with local recurrence |
6 | PET, RX, CT | 48 months | L2 | Yes | Yes | No | Yes | 4 0 | No | E | E | 3–6 A–D | Chemotherapy | E | 4, alive with local disease control |
7 | RMN, CT and bone biopsy | Not reported | T6 | No | Yes | No | Yes | 3 1 | No | Not reported | E | 2–9 A–E | Chemo-radiotherapy | E | 18, dead |
8 | PET, MRI, CT | 72 months | L4 | No | No | No | Yes | Not valuable | No | E | E | 12–7 A–D | Chemotherapy | E | 22, alive with local recurrence |
9 | Bone biopsy, RX, CT | 96 months | L2 | Yes | No | No | Yes | 4 4 | No | E | D2 | 4–5 A | Radiotherapy | Unknown | 0, dead |
10 | Bone biopsy, CT | 6 months | L1 | Yes | No | Yes | Yes | 2 1 | Radio-chemotherapy | E | E | 7–9 A–C | Radiotherapy | E | 22, alive with local recurrence |
11 | Bone biopsy, CT | 15 months | L5 | No | Yes | No | Yes | 4 1 | Radiotherapy | E | E | 4–9 A–C | No | E | 1, alive with local disease control |
12 | MRI, CT | 48 months | T12 | No | No | Yes | Yes | 4 0 | Radio-chemotherapy | D3 | D3 | 1–12 A–D | No | Unknown | 5, alive with local disease control |
13 | PET, RX, CT | 15 months | L5 | No | Yes | No | Yes | 8 1 | Radio-chemotherapy | E | E | 4–6 A–D | No | E | 4, alive with local disease control |
Patient | Surgery Type | Surgical Approach | Spacer Use | Surgery Margins | Contaminated Margins | Surgical Complications |
---|---|---|---|---|---|---|
1 | Palliative | Posterior | None | Intralesional | Yes | No |
2 | Curettage-intracapsular | Posterior | Titanium cage | Intralesional | Yes | No |
3 | Curettage | Posterior | Cement | Intralesional | Yes | No |
4 | Curettage | Posterior | Cement | Intralesional | Yes | No |
5 | Curettage-intracapsular | Posterior | Allograft | Intralesional | Yes | No |
6 | Curettage-intracapsular | Posterior | None | Intralesional | Yes | No |
7 | Curettage | Posterior | None | Intralesional | Yes | No |
8 | Curettage-intracapsular | Posterior | Cement | Intralesional | Yes | No |
9 | Curettage-intracapsular | Anterior | None | Intralesional | Yes | No |
10 | En bloc wide | Anterior + posterior | Custom made titanium cage | Wide | No | Late post-operative: lower flat depression of L3 and L4 vertebrae, degeneration under the instrumentation |
11 | Curettage | Posterior | None | Intralesional | Yes | No |
12 | Curettage | Posterior | None | Intralesional | Yes | Intra-operative: dural injury |
13 | Curettage | Posterior | Cement | Intralesional | Yes | No |
Time of Event (Month) | Number of Deaths | Live Patients | Estimated Probability | Survival Probability at Time of Event | |
---|---|---|---|---|---|
Death | Survival | ||||
0 | 1 | 11 | 0.0909 | 0.9091 | 0.9091 |
5 | 1 | 10 | 0.1000 | 0.9000 | 0.8182 |
18 | 1 | 9 | 0.1111 | 0.8889 | 0.7273 |
19 | 1 | 8 | 0.1250 | 0.8750 | 0.6364 |
R2 | Scale (λ) | Shape (k) | t½ (month) | t¼ (month) |
---|---|---|---|---|
0.45 | 39.0649 | 2.4746 | 29 | 51 |
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Bandiera, S.; Salamanna, F.; Borsari, V.; Contartese, D.; Bontempi, M.; Tschon, M.; Tosini, G.; Pasini, S.; Terzi, S.; Fini, M.; et al. Clinical and Pathological Profiles of Vertebral Bone Metastases from Endometrial Cancers: Evidence from a Twenty-Year Case Series. Diagnostics 2022, 12, 2941. https://doi.org/10.3390/diagnostics12122941
Bandiera S, Salamanna F, Borsari V, Contartese D, Bontempi M, Tschon M, Tosini G, Pasini S, Terzi S, Fini M, et al. Clinical and Pathological Profiles of Vertebral Bone Metastases from Endometrial Cancers: Evidence from a Twenty-Year Case Series. Diagnostics. 2022; 12(12):2941. https://doi.org/10.3390/diagnostics12122941
Chicago/Turabian StyleBandiera, Stefano, Francesca Salamanna, Veronica Borsari, Deyanira Contartese, Marco Bontempi, Matilde Tschon, Giovanni Tosini, Stefano Pasini, Silvia Terzi, Milena Fini, and et al. 2022. "Clinical and Pathological Profiles of Vertebral Bone Metastases from Endometrial Cancers: Evidence from a Twenty-Year Case Series" Diagnostics 12, no. 12: 2941. https://doi.org/10.3390/diagnostics12122941