The Impact of Lung Carcinoma Histology on the Frequency of Bone Metastases

Oliveira, Marcelo Bragança dos Reis; Souza, Larissa Costa; Sampayo, Ermides Javier Garcia; Carvalho, Gustavo Sobral de; Mello, Fernanda Carvalho de Queiroz; Paschoal, Marcos Eduardo Machado

doi:10.1016/j.rbo.2018.02.002

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Sumário

Original Article • Rev. bras. ortop. 54 (5) • Sep-Oct 2019 • https://doi.org/10.1016/j.rbo.2018.02.002 copy

The Impact of Lung Carcinoma Histology on the Frequency of Bone Metastases^* * Work performed at Trauma and Orthopedics Service, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. Originally published by Elsevier Ltda.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Lung cancer is the leading cause of death by cancer, and the bones are one of the most common sites of metastasis from this condition. This study aimed to evaluate the influence of lung carcinoma histology on the frequency of bone metastases.

Methods

This retrospective study evaluated the medical records of 407 patients diagnosed with lung cancer between 2003 and 2012. The prevalence of bone metastases and their association with histological subtypes were evaluated using chi-squared tests, odds ratios (ORs) and 95% confidence intervals (CIs). The overall survival was evaluated using the Kaplan-Meier method.

Results

The prevalence of bone metastases was 28.2% (n = 115), and the spine was the most frequently affected site (98 metastases; 32.1%). Adenocarcinoma was the most common histological subtype of lung carcinoma (46.7%), and it was significantly more frequent among patients with bone metastases (58.3% versus 42.1%; p = 0.003; OR = 1.92; 95% CI: 1.29–2.97). Squamous cell carcinoma was significantly less frequent among patients with bone metastases (13.0% versus 29.8%; p = 0.0004; OR = 0.35; 95% CI: 0.19–0.64). The median survival time after the first bone metastasis diagnosis was 4 months.

Conclusion

Adenocarcinoma was the most common histological subtype of lung carcinoma, and it was significantly associated with a higher risk of developing bone metastases.

Keywords
lung neoplasms; neoplasm metastasis; histology

Characteristic	Patients with lung carcinoma		Patients with lung carcinoma		Patients with lung carcinoma
	General cohort		Without bone metastasis		With bone metastasis
	n = 407		n = 292		n = 115
	n	%	n	%	n	%
Average age (range)	63.4 years-old (32-87)		65.7 years-old (42-84)		62.6 years-old (32-87)
Gender
Male	250	61.4	175	59.3	75	65.2
Female	157	38.6	117	40.7	40	34.8
Smoking
Never smoke	55	13.5	30	10.3	25	21.7
< 40 packs/year	96	23.6	63	21.6	33	28.7
≥ 40 packs/year	256	62.9	199	68.1	57	49.6
Histology
Adenocarcinoma	190	46.7	123	42.1	67	58.3
Squamous cell carcinoma	102	25.1	87	29.8	15	13
Large cell lung cancer	11	2.7	9	3.1	2	1.8
Non-small cell lung cancer, unspecified	56	13.7	40	13.7	16	13.9
Small cell lung cancer	48	11.8	33	11.3	15	13

Histology	Odds ratio	95% confidence interval
Adenocarcinoma	1.92	1.29-2.97
Squamous cell carcinoma	0.35	0.19-0.64
Large cell lung cancer	0.55	0.12-2.61
Non-small cell lung cancer, unspecified	1.01	0.54-1.90
Small cell lung cancer	1.17	0.61-2.26

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Marcelo Bragança dos Reis Oliveira, MD, PhD, Serviço de Traumato-Ortopedia, Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho, (HUCFF), Rio de Janeiro, RJ, 21941-590, Brasil (e-mail: marceloreis@hucff.ufrj.br).

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The Impact of Lung Carcinoma Histology on the Frequency of Bone Metastases* * Work performed at Trauma and Orthopedics Service, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. Originally published by Elsevier Ltda.

Abstract

Objective

Methods

Results

Conclusion

The Impact of Lung Carcinoma Histology on the Frequency of Bone Metastases^* * Work performed at Trauma and Orthopedics Service, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. Originally published by Elsevier Ltda.