PLoS ONE (Jan 2013)

Natural history of malignant bone disease in renal cancer: final results of an Italian bone metastasis survey.

  • Daniele Santini,
  • Giuseppe Procopio,
  • Camillo Porta,
  • Toni Ibrahim,
  • Sandro Barni,
  • Calogero Mazzara,
  • Andrea Fontana,
  • Alfredo Berruti,
  • Rossana Berardi,
  • Bruno Vincenzi,
  • Cinzia Ortega,
  • Davide Ottaviani,
  • Giacomo Carteni,
  • Gaetano Lanzetta,
  • Vladimir Virzì,
  • Matteo Santoni,
  • Nicola Silvestris,
  • Maria Antonietta Satolli,
  • Elena Collovà,
  • Antonio Russo,
  • Giuseppe Badalamenti,
  • Stefano Luzi Fedeli,
  • Francesca Maria Tanca,
  • Vincenzo Adamo,
  • Evaristo Maiello,
  • Roberto Sabbatini,
  • Alessandra Felici,
  • Saverio Cinieri,
  • Giuseppe Tonini,
  • Sergio Bracarda

DOI
https://doi.org/10.1371/journal.pone.0083026
Journal volume & issue
Vol. 8, no. 12
p. e83026

Abstract

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BackgroundBone metastasis represents an increasing clinical problem in advanced renal cell carcinoma (RCC) as disease-related survival improves. There are few data on the natural history of bone disease in RCC.Patients and methodsData on clinicopathology, survival, skeletal-related events (SREs), and bone-directed therapies for 398 deceased RCC patients (286 male, 112 female) with evidence of bone metastasis were statistically analyzed.ResultsMedian time to bone metastasis was 25 months for patients without bone metastasis at diagnosis. Median time to diagnosis of bone metastasis by MSKCC risk was 24 months for good, 5 months for intermediate, and 0 months for poor risk. Median number of SREs/patient was one, and 71% of patients experienced at least one SRE. Median times to first, second, and third SRE were 2, 5, and 12 months, respectively. Median survival was 12 months after bone metastasis diagnosis and 10 months after first SRE. Among 181 patients who received zoledronic acid (ZOL), median time to first SRE was significantly prolonged versus control (n = 186) (3 months vs 1 month for control; PConclusionsRCC patients with bone metastasis are at continuous risk of SREs, and in this survey ZOL effectively reduced this risk.