Bone metastases as the only metastatic site in patients with urothelial carcinoma: Focus on a special patient population
Bone metastases as the only metastatic site in patients with urothelial carcinoma: Focus on a special patient population
BACKGROUND: Patients with exclusive bone metastatic spread from urothelial carcinoma (UC) throughout their disease course represent a rare subgroup with unique clinical features. These patients deserved special consideration in a retrospective multicenter study.
PATIENTS AND METHODS: Analyses were made from a pool of 1911 patients with a diagnosis of metastatic UC, from 23 centers. Baseline characteristics, access to treatment, and outcomes were analyzed according to metastatic spread. Univariable and multivariable Cox analyses were performed.
RESULTS: A total of 128 evaluable patients (6.7%), diagnosed between February 1997 and April 2013, were identified. Eastern Cooperative Oncology Group performance status (PS) was ≥ 2 in 33.3% versus 17.7% of the remaining patients. Seventy-three (57%) received first-line chemotherapy, that was platinum-based in 50 patients (69%). Twenty-eight (21.9%) received second-line chemotherapy (vs. 75.9% and 32.2%, respectively, of the remaining patients). In multivariable analyses, no clinical factor was significantly associated with overall survival (OS). Among platinum chemotherapy-treated patients (total evaluable n = 972), significantly different relapse-free survival (RFS) and OS were observed according to bone metastases status (no bone metastases vs. bone metastases only vs. bone and other sites, P < .001). In these groups, 2-year RFS was 37.4%, 28.8%, and 25.9%, respectively. Two-year OS was 35.5%, 15.8%, and 23%, respectively.
CONCLUSION: Patients with metastatic UC and bone-only metastases are less likely to receive systemic therapy than those with other metastases, likely because of their lower PS. The prognostic effect of having exclusive bone metastases or additional sites seems to be equally poor. These patients deserve new effective and tolerable agents, and improvements in the knowledge of their disease.
Journal Article
Necchi, Andrea
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Pond, Gregory R.
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Pal, Sumanta K.
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Agarwal, Neeraj
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Bowles, Daniel W.
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Plimack, Elizabeth R.
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Yu, Evan Y.
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Ladoire, Sylvain
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Baniel, Jack
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Crabb, Simon
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Niegisch, Gunter
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Srinivas, Sandy
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Berthold, Dominik R.
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Rosenberg, Jonathan E.
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Powles, Thomas
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Bamias, Aristotelis
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Harshman, Lauren C.
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Bellmunt, Joaquim
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Galsky, Matthew D.
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Retrospective International Study of Invasive/Advanced Cancer of the Urothelium Group
Necchi, Andrea
fb44790a-f8fe-43b6-ad82-72cf5b9107d6
Pond, Gregory R.
4bb3025c-b5e3-49c6-87e8-3d4eeca8ef0f
Pal, Sumanta K.
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Agarwal, Neeraj
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Bowles, Daniel W.
8456712b-04a7-4046-8847-3e7280fa480c
Plimack, Elizabeth R.
1813cdc7-c75c-4161-834c-6dc10354c973
Yu, Evan Y.
3f986437-70b2-4993-90d9-13d06e155d8c
Ladoire, Sylvain
62c6053f-7695-4c1e-aa07-eeb98caaf17e
Baniel, Jack
fce42171-4c34-4bc1-896b-484471830852
Crabb, Simon
bcd1b566-7677-4f81-8429-3ab0e85f8373
Niegisch, Gunter
9b94435f-5bb8-47a5-a2c6-39303c8116bd
Srinivas, Sandy
4dd68ce5-fe05-4613-b029-49082edacc32
Berthold, Dominik R.
e3f702dd-1dc5-48cc-84dd-175b31bb79a9
Rosenberg, Jonathan E.
b9e011ca-9408-4366-baea-5f487a246938
Powles, Thomas
55539b87-1c5e-45ae-9e07-5b2232c2236c
Bamias, Aristotelis
d7ea23db-1f9f-4ad8-bff7-b3316eec610d
Harshman, Lauren C.
65c2410e-23a7-49e4-b2ac-05409f320222
Bellmunt, Joaquim
a9cece8e-55c5-4e2e-bb1f-aec7aa8cba91
Galsky, Matthew D.
57bcde2a-bfea-490b-8a09-8ee8e28563da
Necchi, Andrea, Pond, Gregory R., Pal, Sumanta K., Agarwal, Neeraj, Bowles, Daniel W., Plimack, Elizabeth R., Yu, Evan Y., Ladoire, Sylvain, Baniel, Jack, Crabb, Simon, Niegisch, Gunter, Srinivas, Sandy, Berthold, Dominik R., Rosenberg, Jonathan E., Powles, Thomas, Bamias, Aristotelis, Harshman, Lauren C., Bellmunt, Joaquim and Galsky, Matthew D.
,
Retrospective International Study of Invasive/Advanced Cancer of the Urothelium Group
(2017)
Bone metastases as the only metastatic site in patients with urothelial carcinoma: Focus on a special patient population.
Clinical Genitourinary Cancer.
(doi:10.1016/j.clgc.2017.10.012).
Abstract
BACKGROUND: Patients with exclusive bone metastatic spread from urothelial carcinoma (UC) throughout their disease course represent a rare subgroup with unique clinical features. These patients deserved special consideration in a retrospective multicenter study.
PATIENTS AND METHODS: Analyses were made from a pool of 1911 patients with a diagnosis of metastatic UC, from 23 centers. Baseline characteristics, access to treatment, and outcomes were analyzed according to metastatic spread. Univariable and multivariable Cox analyses were performed.
RESULTS: A total of 128 evaluable patients (6.7%), diagnosed between February 1997 and April 2013, were identified. Eastern Cooperative Oncology Group performance status (PS) was ≥ 2 in 33.3% versus 17.7% of the remaining patients. Seventy-three (57%) received first-line chemotherapy, that was platinum-based in 50 patients (69%). Twenty-eight (21.9%) received second-line chemotherapy (vs. 75.9% and 32.2%, respectively, of the remaining patients). In multivariable analyses, no clinical factor was significantly associated with overall survival (OS). Among platinum chemotherapy-treated patients (total evaluable n = 972), significantly different relapse-free survival (RFS) and OS were observed according to bone metastases status (no bone metastases vs. bone metastases only vs. bone and other sites, P < .001). In these groups, 2-year RFS was 37.4%, 28.8%, and 25.9%, respectively. Two-year OS was 35.5%, 15.8%, and 23%, respectively.
CONCLUSION: Patients with metastatic UC and bone-only metastases are less likely to receive systemic therapy than those with other metastases, likely because of their lower PS. The prognostic effect of having exclusive bone metastases or additional sites seems to be equally poor. These patients deserve new effective and tolerable agents, and improvements in the knowledge of their disease.
Text
Draft01_JU paper bone mets RISC
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Accepted/In Press date: 23 October 2017
e-pub ahead of print date: 1 November 2017
Keywords:
Journal Article
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Local EPrints ID: 416453
URI: http://eprints.soton.ac.uk/id/eprint/416453
ISSN: 1558-7673
PURE UUID: b3fc64fb-9178-41ed-9cb4-6a22795be654
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Date deposited: 19 Dec 2017 09:45
Last modified: 16 Mar 2024 06:00
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Contributors
Author:
Andrea Necchi
Author:
Gregory R. Pond
Author:
Sumanta K. Pal
Author:
Neeraj Agarwal
Author:
Daniel W. Bowles
Author:
Elizabeth R. Plimack
Author:
Evan Y. Yu
Author:
Sylvain Ladoire
Author:
Jack Baniel
Author:
Gunter Niegisch
Author:
Sandy Srinivas
Author:
Dominik R. Berthold
Author:
Jonathan E. Rosenberg
Author:
Thomas Powles
Author:
Aristotelis Bamias
Author:
Lauren C. Harshman
Author:
Joaquim Bellmunt
Author:
Matthew D. Galsky
Corporate Author: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium Group
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