| Eastern Cooperative Oncology Group performance status predicts bone metastasis in patients presenting with renal cell carcinoma: implication for preoperative bone scans. | |
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MedLine Citation:
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PMID: 15310985 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: We identified a subset of patients with renal cell carcinoma (RCC) who have a high likelihood of presenting with bone metastasis and would most benefit from a preoperative bone scan. MATERIALS AND METHODS: A database of 1,357 patients undergoing nephrectomy and/or immunotherapy for RCC at our institution was queried. Patients presenting with metastasis to the bones were identified and stratified according to T stage, Eastern Cooperative Oncology Group (ECOG) score, musculoskeletal symptoms and alkaline phosphatase. RESULTS: Of the patients 37% presented with metastasis. Bone metastasis was identified in 14% of patients. The incidence of bone metastasis was 5.4%, 13.8%, 15.4% and 28.2% in patients with T1 to T4 lesions, and 1.4%, 19% and 41% in those with an ECOG score of 0 to 2 and greater, respectively. T stage and ECOG score were then integrated. Bone metastasis was confirmed in 0.046%, 3.8%, 1.4% and 0% of patients with T1 to T4/ECOG 0 disease, and in 13.4%, 20%, 21.5% and 31% of those with T1 to T4/ECOG greater than 0 disease, respectively (p < 0.0001). Only 1.4% of patients with an ECOG score of 0 harbored bone metastasis, of whom 71% complained of musculoskeletal pain, 100% manifested extraosseous metastases and 25% had increased alkaline phosphatase at presentation. CONCLUSIONS: Performance status is an important predictor of bone metastasis in patients presenting with presumed RCC lesions. Bone scan should be performed in patients with an ECOG score of greater than 0 regardless of T stage but is unnecessary in those presenting with an ECOG score of 0, particularly when lacking symptoms and extraosseous metastasis. |
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Authors:
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Oleg Shvarts; John S Lam; Hyung L Kim; Ken-ryu Han; Robert Figlin; Arie Belldegrun |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of urology Volume: 172 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-16 Completed Date: 2004-09-03 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 867-70 Citation Subset: AIM; IM |
Affiliation:
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Division of Urologic Oncology, Department of Urology, David Geffen School of Medicine at University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1738, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Alkaline Phosphatase / analysis Bone Neoplasms / diagnosis, radionuclide imaging*, secondary* Carcinoma, Renal Cell / secondary*, surgery Humans Kidney Neoplasms / pathology*, surgery Middle Aged Risk Factors Tumor Markers, Biological / analysis |
| Chemical | |
Reg. No./Substance:
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0/Tumor Markers, Biological; EC 3.1.3.1/Alkaline Phosphatase |
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