Published in:
Open Access
01-12-2013 | Research
Bone metastases in soft tissue sarcoma: a survey of natural history, prognostic value and treatment options
Authors:
Bruno Vincenzi, Anna Maria Frezza, Gaia Schiavon, Daniele Santini, Palma Dileo, Marianna Silletta, Delia Delisi, Francesco Bertoldo, Giuseppe Badalamenti, Giacomo Giulio Baldi, Stefania Zovato, Rossana Berardi, Marco Tucci, Franco Silvestris, Angelo Paolo Dei Tos, Roberto Tirabosco, Jeremy Simon Whelan, Giuseppe Tonini
Published in:
Clinical Sarcoma Research
|
Issue 1/2013
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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.