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GIUSEPPE BADALAMENTI

Bone metastases in soft tissue sarcoma: a survey of natural history, prognostic value and treatment options

  • Authors: Vincenzi, B; Frezza, AM; Schiavon, G; Santini, D; Dileo, P; Silletta, M; Delisi, D; Bertoldo, F; Badalamenti, G; Baldi, GG; Zovato, S; Berardi, R; Tucci, M; Silvestris, F; Dei Tos, AP; Tirabosco, R; Whelan, JS; Tonini, G
  • Publication year: 2013
  • Type: Articolo in rivista (Articolo in rivista)
  • OA Link: http://hdl.handle.net/10447/104474

Abstract

BACKGROUND: We surveyed the natural history of bone metastases in patients affected by soft tissue sarcoma (STS). METHODS: This multicenter retrospective observational study included 135 patients. Histological subtype, characteristics of bone metastases, treatment, skeletal related events (SREs) and disease outcome were recorded. RESULTS: The most represented histological subtypes were leiomyosarcoma (27%) angiosarcoma (13%) and undifferentiated sarcoma (8%). Axial skeleton was the most common site for bone involvement (70%). In 27% of cases, bone metastases were present at the time of diagnosis. Fifty-four (40%) patients developed SREs and the median time to first SRE was 4 months (range 1-9). The most common SRE was the need for radiotherapy (28%) followed by pathological fracture (22%). Median survival after bone progression was 6 months (range 1-14). SREs were associated with decreased overall survival (OS) (P = 0.04). A subgroup analysis revealed that bisphosphonates significantly prolonged median time to first SRE (5 versus 2 months; P = 0.002) while they did not determine an improvement in OS, although a favourable trend was identified (median: 7 versus 5 months; P = 0.105). CONCLUSIONS: This study illustrates the burden of bone disease from STS and supports the use of bisphosphonates in this setting.