Natural history of bone metastasis in colorectal cancer: final results of a large Italian bone metastases study.
BACKGROUND
Data are limited regarding bone metastases from colorectal cancer (CRC). The objective of this study was to survey the natural history of bone metastasis in CRC.


METHODS
This retrospective, multicenter, observational study of 264 patients with CRC involving bone examined cancer treatments, bone metastases characteristics, skeletal-related event (SRE) type and frequency, zoledronic acid therapy, and disease outcomes.


RESULTS
Most patients with bone metastases had pathologic T3/4 disease at CRC diagnosis. The spine was the most common site involved (65%), followed by hip/pelvis (34%), long bones (26%), and other sites (17%). Median time from CRC diagnosis to bone metastases was 11.00 months; median time to first SRE thereafter was 2.00 months. Radiation and pathologic fractures affected 45% and 10% of patients, respectively; 32% of patients had no reported SREs. Patients survived for a median of 7.00 months after bone metastases diagnosis; SREs did not significantly affect survival. Subgroup analyses revealed that zoledronic acid significantly prolonged median time to first SRE (2.00 months versus 1.00 month, respectively, P=0.009) and produced a trend toward improved overall survival versus no zoledronic acid.


CONCLUSIONS
This study illustrates the burden of bone metastases from CRC and supports the use of zoledronic acid in this setting.
Department of Medical Oncology, University Campus Bio-Medico, Rome. Electronic address: d.santini@unicampus.it.
D
D
Santini
Department of Medical Oncology, University of Torino, San Luigi Hospital, Orbassano, Torino.
M
M
Tampellini
Department of Medical Oncology, University Campus Bio-Medico, Rome.
B
B
Vincenzi
Osteo-oncology Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Forlì-Cesena.
T
T
Ibrahim
Oncological Department, Medical Oncology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino.
C
C
Ortega
Department of Medical Oncology, University Campus Bio-Medico, Rome.
V
V
Virzi
Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari.
N
N
Silvestris
Department of Medical Oncology, Universita Politecnica delle Marche, Ancona.
R
R
Berardi
Department of Medical Oncology, University Hospital, Modena.
C
C
Masini
Department of Radiotherapy, Ospedali Riuniti, Reggio Calabria.
N
N
Calipari
Department of Medical Oncology, Presidio Sanitario Gradenigo, Turin.
D
D
Ottaviani
Department of Medical Oncology, A.O. Ospedali Riuniti Marche Nord, Pesaro.
V
V
Catalano
Department of Surgery and Oncology, Policlinico Universitario 'P. Giaccone', Palermo.
G
G
Badalamenti
Department of Medical Oncology, Ospedali Riuniti, Reggio Calabria.
R
R
Giannicola
Osteo-oncology Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Forlì-Cesena.
F
F
Fabbri
Department of Medical Oncology, University Campus Bio-Medico, Rome.
O
O
Venditti
Department of Medical Oncology, University Campus Bio-Medico, Rome.
M E
ME
Fratto
Department of Medical Oncology, University Campus Bio-Medico, Rome.
C
C
Mazzara
Department of Onco-Hematology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo.
T P
TP
Latiano
Department of Medical Oncology, University Hospital, Modena.
F
F
Bertolini
Department of Medical Oncology, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, Bergamo.
F
F
Petrelli
Department of Medical Oncology, University of Torino, San Luigi Hospital, Orbassano, Torino.
A
A
Ottone
S.C. Medical Oncology, Galliera Hospital, Genoa.
C
C
Caroti
Division of Medical Oncology, Department of Oncology, University Hospital S. Chiara, Pisa.
L
L
Salvatore
Division of Medical Oncology, Department of Oncology, University Hospital S. Chiara, Pisa.
A
A
Falcone
Department of Medical Oncology, A.O. Ospedali Riuniti Marche Nord, Pesaro.
P
P
Giordani
Department of Medical Oncology, Ospedale San Giovanni di Dio di Frattamaggiore, Naples.
R
R
Addeo
Oncological Department, Medical Oncology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino; Department of Clinical Oncology, University of Torino Medical School - Institute for Cancer Research and Treatment, Candiolo, Torino, Italy.
M
M
Aglietta
Department of Medical Oncology, Universita Politecnica delle Marche, Ancona.
S
S
Cascinu
Department of Medical Oncology, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, Bergamo.
S
S
Barni
Department of Onco-Hematology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo.
E
E
Maiello
Department of Medical Oncology, University Campus Bio-Medico, Rome.
G
G
Tonini
D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D012189:Retrospective Studies; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid