Source: Annual Congress 2002 - Thoracic oncology: clinical management
Disease area: Thoracic oncology

Abstract

Correct detection of bone metastases in patients with NSCLC is crucial for the patients' prognosis and selection of appropriate treatment regimen. The aim of this study was to investigate the role of whole body bone scanning (BS) and clinical factors (CF) in detecting bone metastases in NSCLC. 118 patients diagnosed having lung cancer between 1998-2001 were recruited (squamous cell carcinoma 53,4%; adenocarcinoma 33,1%; non-small cell 9,3%; large cell 4,2%). CF suggesting bone metastasis (skeletal pain, elevated alkaline phosphatase, hypercalcemia) were recorded. BS was performed in all patients but one, and additional MRI was ordered in 14 patients because of discordance between CF and BS findings. Bone metastases were detected in 56,4% (n=22) of 39 CF-positive patients; 6,3% (n=5) of 79 CF-negative patients and in 22,9 % totally. Adenocarcinoma was the most common cell type found in patients with bone metastasis(41%); squamous cell (12,7%) and non-small cell carcinoma (27,3%) followed this. BS results in patients with MRI were as follows: false-positive (n=4); true-positive (n=3); false-negative (n=1), true-negative (n=1). MRI results of 5 patients with suspicious bone metastasis regarding BS showed no metastasis in 4. 3 of 18 patients with T2N0 disease had bone metastasis. 2 of them with CF, one without CF and with squamous cell carcinoma.
Adenocarcinoma is the most common cell type in patients with bone metastasis. Bone metastases may occur without clinical factors suggestive of them and also without CT evidence of enlarged hilar or mediastinal lymph nodes. In patients for whom surgical therapy is an option, preoperative staging using BS can be helpful to avoid misstaging due to asymptomatic bone metastases.

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M. Yaman, S. Erturan, G. Aydin, I. Talasli, A. N. Annakkaya, S. Cömert, E. Duman (Istanbul, Turkey). Detection of bone metastases in patients with NSCLC. Eur Respir J 2002; 20: Suppl. 38, 1184

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