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Bone Metastases and Skeletal-Related Events in Medullary Thyroid Carcinoma

Context: Bone metastases (BM) can lead to devastating skeletal-related events (SREs) in cancer patients. Data regarding medullary thyroid carcinoma (MTC) with BM are lacking. Objective: We evaluated the natural history of BM and SREs in MTC patients identified by a cancer center tumor registry. Sett... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2016, Vol.101 (12), p.4871-4877
Main Author: Xu, Jian Yu
Other Authors: Murphy, William A , Milton, Denái R , Jimenez, Camilo , Rao, Sarika N , Habra, Mouhammed Amir , Waguespack, Steven G , Dadu, Ramona , Gagel, Robert F , Ying, Anita K , Cabanillas, Maria E , Weitzman, Steven P , Busaidy, Naifa L , Sellin, Rena V , Grubbs, Elizabeth , Sherman, Steven I , Hu, Mimi I
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Endocrine Society
ID: ISSN: 0021-972X
Link: https://www.ncbi.nlm.nih.gov/pubmed/27662441
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title: Bone Metastases and Skeletal-Related Events in Medullary Thyroid Carcinoma
format: Article
creator:
  • Xu, Jian Yu
  • Murphy, William A
  • Milton, Denái R
  • Jimenez, Camilo
  • Rao, Sarika N
  • Habra, Mouhammed Amir
  • Waguespack, Steven G
  • Dadu, Ramona
  • Gagel, Robert F
  • Ying, Anita K
  • Cabanillas, Maria E
  • Weitzman, Steven P
  • Busaidy, Naifa L
  • Sellin, Rena V
  • Grubbs, Elizabeth
  • Sherman, Steven I
  • Hu, Mimi I
subjects:
  • Abridged Index Medicus
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Neoplasms - complications
  • Bone Neoplasms - epidemiology
  • Bone Neoplasms - pathology
  • Bone Neoplasms - secondary
  • Carcinoma, Neuroendocrine - epidemiology
  • Carcinoma, Neuroendocrine - pathology
  • Child
  • Female
  • humanities
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Original
  • Original Articles
  • Registries
  • Retrospective Studies
  • Spinal Cord Compression - epidemiology
  • Spinal Cord Compression - etiology
  • Spinal Fractures - epidemiology
  • Spinal Fractures - etiology
  • Thyroid Neoplasms - epidemiology
  • Thyroid Neoplasms - pathology
  • Young Adult
ispartof: The journal of clinical endocrinology and metabolism, 2016, Vol.101 (12), p.4871-4877
description: Context: Bone metastases (BM) can lead to devastating skeletal-related events (SREs) in cancer patients. Data regarding medullary thyroid carcinoma (MTC) with BM are lacking. Objective: We evaluated the natural history of BM and SREs in MTC patients identified by a cancer center tumor registry. Setting: The study was conducted at a tertiary cancer center. Patients and Main Outcome Measures: We retrospectively reviewed the charts of MTC patients with BM who received care from 1991 to 2014 to characterize BM and SREs. Results: Of 1008 MTC patients treated, 188 were confirmed to have BM (19%), of whom 89% (168 of 188) had nonosseous distant metastases. Median time from MTC to BM diagnosis was 30.9 months (range 0–533 mo); 25% (45 of 180) had BM identified within 3 months of MTC diagnosis. Median follow-up after detecting BM was 1.6 years (range 0–23.2 y). Most patients (77%) had six or more BM lesions, most often affecting the spine (92%) and pelvis (69%). Many patients (90 of 188, 48%) experienced one or more SREs, most commonly radiotherapy (67 of 90, 74%) followed by pathological fracture (21 of 90, 23%). Only three patients had spinal cord compression. Patients with more than 10 BM lesions were more likely to experience SREs (odds ratio 2.4; P = .007), with no difference in 5-year mortality after MTC diagnosis between patients with (31%) and without SREs (23%) (P = .11). Conclusions: In this large retrospective series, BM in MTC was multifocal, primarily involving the spine and pelvis, supporting screening these regions for metastases in at-risk patients. SREs were common but spinal cord compression was rare. Antiresorptive therapies in this population should be investigated further with prospective trials. We studied the characteristics and clinical behavior of bone metastases in medullary thyroid cancer patients and found they are often multifocal and that SREs are common.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


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titleBone Metastases and Skeletal-Related Events in Medullary Thyroid Carcinoma
creatorXu, Jian Yu ; Murphy, William A ; Milton, Denái R ; Jimenez, Camilo ; Rao, Sarika N ; Habra, Mouhammed Amir ; Waguespack, Steven G ; Dadu, Ramona ; Gagel, Robert F ; Ying, Anita K ; Cabanillas, Maria E ; Weitzman, Steven P ; Busaidy, Naifa L ; Sellin, Rena V ; Grubbs, Elizabeth ; Sherman, Steven I ; Hu, Mimi I
creatorcontribXu, Jian Yu ; Murphy, William A ; Milton, Denái R ; Jimenez, Camilo ; Rao, Sarika N ; Habra, Mouhammed Amir ; Waguespack, Steven G ; Dadu, Ramona ; Gagel, Robert F ; Ying, Anita K ; Cabanillas, Maria E ; Weitzman, Steven P ; Busaidy, Naifa L ; Sellin, Rena V ; Grubbs, Elizabeth ; Sherman, Steven I ; Hu, Mimi I
descriptionContext: Bone metastases (BM) can lead to devastating skeletal-related events (SREs) in cancer patients. Data regarding medullary thyroid carcinoma (MTC) with BM are lacking. Objective: We evaluated the natural history of BM and SREs in MTC patients identified by a cancer center tumor registry. Setting: The study was conducted at a tertiary cancer center. Patients and Main Outcome Measures: We retrospectively reviewed the charts of MTC patients with BM who received care from 1991 to 2014 to characterize BM and SREs. Results: Of 1008 MTC patients treated, 188 were confirmed to have BM (19%), of whom 89% (168 of 188) had nonosseous distant metastases. Median time from MTC to BM diagnosis was 30.9 months (range 0–533 mo); 25% (45 of 180) had BM identified within 3 months of MTC diagnosis. Median follow-up after detecting BM was 1.6 years (range 0–23.2 y). Most patients (77%) had six or more BM lesions, most often affecting the spine (92%) and pelvis (69%). Many patients (90 of 188, 48%) experienced one or more SREs, most commonly radiotherapy (67 of 90, 74%) followed by pathological fracture (21 of 90, 23%). Only three patients had spinal cord compression. Patients with more than 10 BM lesions were more likely to experience SREs (odds ratio 2.4; P = .007), with no difference in 5-year mortality after MTC diagnosis between patients with (31%) and without SREs (23%) (P = .11). Conclusions: In this large retrospective series, BM in MTC was multifocal, primarily involving the spine and pelvis, supporting screening these regions for metastases in at-risk patients. SREs were common but spinal cord compression was rare. Antiresorptive therapies in this population should be investigated further with prospective trials. We studied the characteristics and clinical behavior of bone metastases in medullary thyroid cancer patients and found they are often multifocal and that SREs are common.
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subjectAbridged Index Medicus ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms - complications ; Bone Neoplasms - epidemiology ; Bone Neoplasms - pathology ; Bone Neoplasms - secondary ; Carcinoma, Neuroendocrine - epidemiology ; Carcinoma, Neuroendocrine - pathology ; Child ; Female ; humanities ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Original ; Original Articles ; Registries ; Retrospective Studies ; Spinal Cord Compression - epidemiology ; Spinal Cord Compression - etiology ; Spinal Fractures - epidemiology ; Spinal Fractures - etiology ; Thyroid Neoplasms - epidemiology ; Thyroid Neoplasms - pathology ; Young Adult
ispartofThe journal of clinical endocrinology and metabolism, 2016, Vol.101 (12), p.4871-4877
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1Murphy, William A
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7Dadu, Ramona
8Gagel, Robert F
9Ying, Anita K
10Cabanillas, Maria E
11Weitzman, Steven P
12Busaidy, Naifa L
13Sellin, Rena V
14Grubbs, Elizabeth
15Sherman, Steven I
16Hu, Mimi I
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descriptionContext: Bone metastases (BM) can lead to devastating skeletal-related events (SREs) in cancer patients. Data regarding medullary thyroid carcinoma (MTC) with BM are lacking. Objective: We evaluated the natural history of BM and SREs in MTC patients identified by a cancer center tumor registry. Setting: The study was conducted at a tertiary cancer center. Patients and Main Outcome Measures: We retrospectively reviewed the charts of MTC patients with BM who received care from 1991 to 2014 to characterize BM and SREs. Results: Of 1008 MTC patients treated, 188 were confirmed to have BM (19%), of whom 89% (168 of 188) had nonosseous distant metastases. Median time from MTC to BM diagnosis was 30.9 months (range 0–533 mo); 25% (45 of 180) had BM identified within 3 months of MTC diagnosis. Median follow-up after detecting BM was 1.6 years (range 0–23.2 y). Most patients (77%) had six or more BM lesions, most often affecting the spine (92%) and pelvis (69%). Many patients (90 of 188, 48%) experienced one or more SREs, most commonly radiotherapy (67 of 90, 74%) followed by pathological fracture (21 of 90, 23%). Only three patients had spinal cord compression. Patients with more than 10 BM lesions were more likely to experience SREs (odds ratio 2.4; P = .007), with no difference in 5-year mortality after MTC diagnosis between patients with (31%) and without SREs (23%) (P = .11). Conclusions: In this large retrospective series, BM in MTC was multifocal, primarily involving the spine and pelvis, supporting screening these regions for metastases in at-risk patients. SREs were common but spinal cord compression was rare. Antiresorptive therapies in this population should be investigated further with prospective trials. We studied the characteristics and clinical behavior of bone metastases in medullary thyroid cancer patients and found they are often multifocal and that SREs are common.
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5Bone Neoplasms - complications
6Bone Neoplasms - epidemiology
7Bone Neoplasms - pathology
8Bone Neoplasms - secondary
9Carcinoma, Neuroendocrine - epidemiology
10Carcinoma, Neuroendocrine - pathology
11Child
12Female
13humanities
14Humans
15Male
16Middle Aged
17Neoplasm Metastasis
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19Original Articles
20Registries
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22Spinal Cord Compression - epidemiology
23Spinal Cord Compression - etiology
24Spinal Fractures - epidemiology
25Spinal Fractures - etiology
26Thyroid Neoplasms - epidemiology
27Thyroid Neoplasms - pathology
28Young Adult
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7Dadu, Ramona
8Gagel, Robert F
9Ying, Anita K
10Cabanillas, Maria E
11Weitzman, Steven P
12Busaidy, Naifa L
13Sellin, Rena V
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titleBone Metastases and Skeletal-Related Events in Medullary Thyroid Carcinoma
authorXu, Jian Yu ; Murphy, William A ; Milton, Denái R ; Jimenez, Camilo ; Rao, Sarika N ; Habra, Mouhammed Amir ; Waguespack, Steven G ; Dadu, Ramona ; Gagel, Robert F ; Ying, Anita K ; Cabanillas, Maria E ; Weitzman, Steven P ; Busaidy, Naifa L ; Sellin, Rena V ; Grubbs, Elizabeth ; Sherman, Steven I ; Hu, Mimi I
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7Bone Neoplasms - pathology
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9Carcinoma, Neuroendocrine - epidemiology
10Carcinoma, Neuroendocrine - pathology
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20Registries
21Retrospective Studies
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23Spinal Cord Compression - etiology
24Spinal Fractures - epidemiology
25Spinal Fractures - etiology
26Thyroid Neoplasms - epidemiology
27Thyroid Neoplasms - pathology
28Young Adult
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7Dadu, Ramona
8Gagel, Robert F
9Ying, Anita K
10Cabanillas, Maria E
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12Busaidy, Naifa L
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7Dadu, Ramona
8Gagel, Robert F
9Ying, Anita K
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notesThis work was supported in part by The University of Texas M. D. Anderson Cancer Center's Cancer Center Support Grant CA16672 (National Institutes of Health/National Cancer Institute).
abstractContext: Bone metastases (BM) can lead to devastating skeletal-related events (SREs) in cancer patients. Data regarding medullary thyroid carcinoma (MTC) with BM are lacking. Objective: We evaluated the natural history of BM and SREs in MTC patients identified by a cancer center tumor registry. Setting: The study was conducted at a tertiary cancer center. Patients and Main Outcome Measures: We retrospectively reviewed the charts of MTC patients with BM who received care from 1991 to 2014 to characterize BM and SREs. Results: Of 1008 MTC patients treated, 188 were confirmed to have BM (19%), of whom 89% (168 of 188) had nonosseous distant metastases. Median time from MTC to BM diagnosis was 30.9 months (range 0–533 mo); 25% (45 of 180) had BM identified within 3 months of MTC diagnosis. Median follow-up after detecting BM was 1.6 years (range 0–23.2 y). Most patients (77%) had six or more BM lesions, most often affecting the spine (92%) and pelvis (69%). Many patients (90 of 188, 48%) experienced one or more SREs, most commonly radiotherapy (67 of 90, 74%) followed by pathological fracture (21 of 90, 23%). Only three patients had spinal cord compression. Patients with more than 10 BM lesions were more likely to experience SREs (odds ratio 2.4; P = .007), with no difference in 5-year mortality after MTC diagnosis between patients with (31%) and without SREs (23%) (P = .11). Conclusions: In this large retrospective series, BM in MTC was multifocal, primarily involving the spine and pelvis, supporting screening these regions for metastases in at-risk patients. SREs were common but spinal cord compression was rare. Antiresorptive therapies in this population should be investigated further with prospective trials. We studied the characteristics and clinical behavior of bone metastases in medullary thyroid cancer patients and found they are often multifocal and that SREs are common.
copUnited States
pubEndocrine Society
pmid27662441
doi10.1210/jc.2016-2815
oafree_for_read