BACKGROUND: The purpose of this study is to compare the survival time of non-small cell lung cancer (NSCLC) patients with different organ metastasis. Among all cancers, the morbidity and mortality of lung cancer is the highest worldwide, which may caused by local recurrence and distant metastasis, and the location of metastasis may predict the prognosis of patients. METHODS: A total of 117,542 patients with NSCLC diagnosed between 2010 and 2014 were enrolled from Surveillance, Epidemiology, and End Result (SEER) databases, and the relationship between distant metastasis and survival time was retrospectively analyzed. RESULTS: Of all the 117,542 patients diagnosed with non-small cell lung cancer, 42,071 (35.8%) patients had different degrees of distant metastasis during their medical history, including 26,932 single organ metastases and 15,139 multiple organ metastases, accounting for 64.0% and 36.0% of the metastatic patients respectively. Compared with patients with no metastasis, whose median survival time was 21 months, the median survival time of patients with metastases was 7 months (lung), 6 months (brain), 5 months (bone), 4 months (liver), and 3 months (multiple organ) respectively, and the difference was significant (P<0.001, except liver vs multiple organ P=0.650); Most patients with NSCLC (88.4%) eventually died of lung cancer. CONCLUSIONS Distant metastasis of NSCLC patients indicates poor prognosis. In NSCLC patients with single organ metastasis, the prognosis of lung metastasis is the best, and liver metastasis is the worst, and multiple organ metastasis is worse than single organ metastasis.
Aged ; Aged, 80 and over ; Bone Neoplasms ; mortality ; secondary ; Brain Neoplasms ; mortality ; secondary ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; Female ; Humans ; Liver Neoplasms ; mortality ; secondary ; Lung Neoplasms ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies

INTRODUCTIONNasopharnygeal carcinoma (NPC) is characterised by early metastases with the skeleton being the most common site of metastases. The ability to prognosticate survival is crucial in the decision whether or not to offer surgery to these patients and the choice of surgery offered. We aimed to evaluate the scoring systems namely: Bauer, Katagiri and Scandinavian Sarcoma Group (SSG) in NPC patients with skeletal metastases.

MATERIALS AND METHODSA total of 92 patients with skeletal metastases from NPC were studied. We retrospectively analysed the actual survival of these patients and compared with predicted survival according to the 3 scoring systems. The predicted survival according to each system was calculated and labelled as A scores. These were then re-scored by assigning NPC as a better prognostic tumour and labelled as B scores. The predicted survival of scores A and B were compared to actual survival. Univariate and multivariate Cox regression analyses were performed. The predictive values of each scoring were calculated.

RESULTSThe median overall survival for the whole cohort was 13 months (range: 1 to 120 months). In multivariate analysis, general condition and visceral metastases showed significant effect on survival. There were statistically significant differences (P <0.001) between the subgroups of the SSG B as well as Katagiri B scoring systems where NPC was classified as a better prognostic tumour. SSG B provided the highest predictive value (0.67) as compared to the other 2 scoring systems.

CONCLUSIONThe SSG and Katagiri score could be used to prognosticate NPC with a statistically significant association with actual survival.

Bone Neoplasms ; mortality ; secondary ; Carcinoma ; mortality ; secondary ; Humans ; Multivariate Analysis ; Nasopharyngeal Neoplasms ; mortality ; pathology ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

INTRODUCTIONMore than 80% of children with osteogenic sarcoma (OS) relapse and 35% to 40% of them die within the first 2 years after diagnosis due to relapse. We investigated the incidence, treatment modalities used and the outcome of patients with OS treated in Singapore.

MATERIALS AND METHODSPatients with OS treated in Department of Paediatrics KK Women's and Children's Hospital (KKH) and National University Hospital (NUH) between January 1994 and June 2011 were reviewed. Chemotherapy was as per the European Osteosarcoma Intergroup (EOI) and as per the Memorial Sloan-Kettering Cancer Centre's (MSKCC) T12 protocols. Overall and event-free (EFS) 5-year survivals were calculated using Kaplan-Meier analysis and Cox proportional hazards regression analysis.

RESULTSOf 66 patients with OS, 19 (29%) of them presented with metastatic OS. The median age of diagnosis was 12.1 years with 5-year overall survival of 61.7% (95% CI, 48.1 to 75.3). The 5-year overall survival for those with non-metastatic and metastatic OS was 73.1% (95% CI, 58.1 to 88.1) and 34.7% (95% CI, 8.7 to 60.7, P=0.007) respectively. The 5-year overall survival for those treated as per the MSKCC T12 and EOI was 72.4% (95% CI, 52.6 to 92.2) and 54.3% (95% CI, 36.3 to 72.3, P=0.087) respectively. After controlling for confounding factors, patients with non-metastatic OS had higher 5-year EFS (HR, 0.228, 95% CI, 0.096 to 0.541, P=0.001) and overall survival (HR, 0.294, 95% CI, 0.121 to 0.713, P=0.007) compared to those with metastatic OS. Non-metastatic OS patients treated as per EOI regimen had lower 5-year EFS (HR, 2.397, 95% CI, 1.012 to 6.678, P=0.047) compared to those treated per MSKCC T12 regimen.

CONCLUSIONMultidrug combination chemotherapy including high-dose methotrexate (HD-MTX) and a multidisciplinary team approach introduced in 2003 in Singapore is well tolerated and can be safely delivered. The survival benefit between the 2 regimens still needs to be explored.

Adolescent ; Bone Neoplasms ; drug therapy ; mortality ; Child ; Child, Preschool ; Female ; Humans ; Male ; Osteosarcoma ; drug therapy ; mortality ; Survival Rate ; Young Adult

Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.
Bone Marrow* ; Diagnosis ; Drug Therapy ; Humans ; Liver ; Mortality ; Neoplasm Metastasis* ; Pancytopenia ; Peritoneum ; Prognosis ; Stomach Neoplasms

Hypertrophic osteoarthropathy is characterized by clubbing of the digital tips and periosteal reaction of long bones. Most of the cases are associated with malignancy or other conditions such as congenital heart disease, liver cirrhosis, pulmonary fibrosis, biliary atresia, and gastrointestinal polyps. Hypertrophic osteoarthropathy associated with malignancy is rare in children. A few cases of hypertrophic osteoarthropathy in children with nasopharyngeal carcinoma have been reported, however, there has been no report of such case in Korea. We present a case of hypertrophic osteoarthropathy associated with nasopharyngeal carcinoma with lung metastasis in a 14-yr-old boy. In this case, hypertrophic osteoarthropathy regressed after intensive chemotherapy, but subsequently the patient died of progressive lung metastasis.
Adolescent ; Bone and Bones/radiography ; Carcinoma/*diagnosis/mortality ; Disease Progression ; Fatal Outcome ; Human ; Joint Diseases/pathology ; Lung Neoplasms/mortality/*secondary ; Male ; Nasopharyngeal Neoplasms/*diagnosis/mortality ; Neoplasm Metastasis ; Osteoarthropathy, Primary Hypertrophic/*diagnosis/mortality/radiography ; Prognosis

BACKGROUND: Small cell lung cancer (SCLC) is highly malignant and prone to bone marrow metastasis in early stage, but its related reports are limited. This study analyzed the clinical feature, laboratory examination, treatment and prognosis of SCLC patients with bone marrow metastasis. METHODS: The clinical data of 26 SCLC patients with bone marrow metastasis were analyzed retrospectively. Prognostic factors were evaluated. RESULTS: The median age of 26 patients was 57 years and the median time from diagnosis of SCLC to confirmed bone marrow metastases was 8 d. Most patients (96.2%) were accompanied by other organ metastases. The most common laboratory abnormalities were elevated lactate dehydrogenase in 19 cases (73.1%), thrombocytopenia and elevated alkaline phosphatase respectively in 11 cases (42.3%) and anemia in 7 cases (26.9%). Twenty patients had received chemotherapy and the remaining 6 patients had not. Of this group, 16 patients received at least 2 cycles of chemotherapy after the diagnosis of bone marrow metastasis. The median survival time was 15.7 wk (0.1 wk-82.9 wk) after diagnosis of bone marrow metastasis. The survival of patients with chemotherapy was significantly better than that of those without chemotherapy (χ²=33.768, P<0.001). Multivariate analysis showed that no chemotherapy was independent poor prognostic factors (P<0.05). CONCLUSIONS The SCLC patients with bone marrow metastasis have short survival, whereas chemotherapy can extend the survival of patients.
Aged ; Bone Marrow ; pathology ; Bone Marrow Neoplasms ; mortality ; pathology ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Retrospective Studies ; Small Cell Lung Carcinoma ; pathology

BACKGROUNDTreating metastatic osteosarcoma has been challenged in past decades. Extracelluar matrix (ECM) proteins play an important role in the progression of osteosarcoma as they are pivotal components of the tumor microenvironment. Here, we identified potential genes belonging to the ECM and characterized the roles of these genes in the progression of osteosarcoma and their association with outcomes.

METHODSOsteosarcoma parental cell line MG63 and its derivative MG63-A1 with a high metastatic potential underwent oligonucleotide microarray analysis. Gene ontology analysis was used to screen deregulated genes between the 2 cell lines which were either upregulated or downregulated by more than 4 fold, particularly focusing on mRNAs encoding extracellular matrix proteins. The expression of resulting candidate genes was then validated by reverse transcription-PCR for mRNA expression as well as Western blotting for protein expression. Immunohistochemistry was performed on 37 osteosarcoma specimens to examine the potential role of the candidate genes in a clinical context.

RESULTSMicroarray data and gene ontology analysis showed that Tenascin-C, a critical component of the ECM, is significantly down-regulated in the highly metastatic cell line MG63-A1 compared with the parental osteosarcoma cell line MG63-wt. This finding was validated at mRNA and protein levels. Immunohistochemical analysis found that Tenascin-C is located in the intercellular space in osteosarcoma specimens. Furthermore, low-grade Tenascin-C expression (less than 20%) in osteosarcoma specimens was associated with poor survival.

CONCLUSIONSTenascin-C expression level correlates with the survival of osteosarcoma patients. Its biological functional role and underlying molecular mechanisms in the progression of osteosarcoma needs further investigation.

Adolescent ; Adult ; Bone Neoplasms ; metabolism ; mortality ; Cell Line, Tumor ; Child ; Female ; Humans ; Male ; Oligonucleotide Array Sequence Analysis ; Osteosarcoma ; metabolism ; mortality ; Prognosis ; RNA, Messenger ; analysis ; Tenascin ; analysis ; genetics

OBJECTIVETo determin the prognostic factors that influence survival in patients with osteosarcma.

METHODSThe clinical data of 43 patients with osteosarcoma between March 2005 and March 2007 were retrospectively reviewed. Patient's sex, age, tumor site, course of disease, serum alkaline phosphatase (AKP) level, preoperative chemotherapy, Enneking surgical stage, surgical method, distant metastasis were analyzed by Kaplan-Meier method, Log-rank test and COX regression model. Kaplan-Meier method was used to calculate the 3-years survival rate, and Log-rank test was used to determin prognostic factors related with survival rate, and COX regression model was used to find the independent prognostic factors. The effect of neoadjuvant chemotherapy on the prognosis of osteosarcoma was analyzed by Fisher exact test.

RESULTSAll the patients were followed up. Twenty-eight patients were alive, while 15 patients were dead. The survival time ranged from 6 to 65 months with a median survival of 42 months. Overall 3-year survival rate was 65.1%. Univariate analysis revealed that the prognosis of osteosarcoma was significantly related to tumor site (P = 0.010), Enneking surgical stage (P = 0.002), surgical method (P = 0.000) and distant metastasis (P = 0.002). Multivariate analysis by COX regression model suggested Enneking surgical stage (P = 0.028),surgical method (P = 0.001) and distant metastasis (P = 0.007) were the independent prognostic factors. Though the preoperative chemotherapy was unrelated to the survival of osteosarcoma, the sensitivity to preoperative chemotherapy was an important factor that affected the prognosis of osteosarcoma (P = 0.007).

CONCLUSIONThe prognosis of osteosarcoma was significantly correlated with Enneking surgical stage, surgical method and distant metastasis, early detection and wide excision were interventional methods to improve the survival of osteosarcoma.

Adolescent ; Adult ; Aged ; Bone Neoplasms ; mortality ; therapy ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Osteosarcoma ; mortality ; therapy ; Prognosis ; Proportional Hazards Models ; Retrospective Studies

OBJECTIVETo explore the long-term survival and prognosis of prostate cancer patients after treated by androgen deprivation therapy.

METHODSWe conducted a follow-up study of 124 patients with prostate cancer treated by androgen deprivation therapy, and compared the survival times of the patients with different pathological grades and clinical characteristics using Kaplan-Meiers survival curves.

RESULTSThe mean survival time of the 124 patients after androgen deprivation therapy was 5. 912 years, with the median survival time of 7.81 years. The patients with bone metastases showed a shorter survival time than those with non-bone metastasis (P = 0.04). Pathological grades and PSA levels were not prognostic factors. No significant differences were found in the mean survival time between those died of prostate cancer (n = 35) and those from other factors (n = 23) (P = 0.50).

CONCLUSIONBone metastasis is an important prognostic factor in advanced prostate cancer following androgen deprivation therapy, which is more significantly correlated with the survival time of the patients than tumor grades and clinical classification.

Adult ; Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Bone Neoplasms ; secondary ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Prostatic Neoplasms ; mortality ; therapy

OBJECTIVETo compare the efficacy of endocrine therapy with chemotherapy for bone metastasis of breast cancer.

METHODSA total of 138 breast cancer patients with bone metastasis, but without visceral metastasis as retrospectively reviewed.

RESULTSThe response rates of endocrine therapy and chemotherapy as the first-line therapy were 35.4% and 31.7% (P = 0.687), and the total response rates were 27.1% and 25.0% (P = 0.690). The clinical benefit rates of endocrine therapy and chemotherapy as first-line were 43.9% and 36.6% (P = 0.437), as second-line were 47.8% and 24.2% (P = 0.033), in total treatments were 47.5% and 27.7% (P = 0.001). The median interval to treatment failure (TTF) was 5 months and 2 months (P < 0.001), and that to progression (TTP) was 5 and 2.5 months (P < 0.001) in endocrine therapy and chemotherapy group, respectively.

CONCLUSIONEndocrine therapy is superior to chemotherapy for bone metastasis of breast cancer.

Antineoplastic Agents ; therapeutic use ; Bone Neoplasms ; secondary ; therapy ; Breast Neoplasms ; mortality ; therapy ; Female ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Failure