title: Natural history of malignant bone disease in gastric cancer: final results of a multicenter bone metastasis survey.
abstract: BACKGROUND
  Bone metastasis represents an increasing clinical problem in advanced gastric cancer (GC) as disease-related survival improves. In literature, few data on the natural history of bone disease in GC are available.
  
  
  METHODS
  Data on clinicopathology, skeletal outcomes, skeletal-related events (SREs), and bone-directed therapies for 208 deceased GC patients with evidence of bone metastasis were statistically analyzed.
  
  
  RESULTS
  Median time to bone metastasis was 8 months (CI 95%, 6.125-9.875 months) considering all included patients. Median number of SREs/patient was one. Less than half of the patients (31%) experienced at least one and only 4 and 2% experienced at least two and three events, respectively. Median times to first and second SRE were 2 and 4 months, respectively. Median survival was 6 months after bone metastasis diagnosis and 3 months after first SRE. Median survival in patients who did not experience SREs was 5 months. Among patients who received zoledronic acid before the first SRE, the median time to appearance of first SRE was significantly prolonged compared to control (7 months vs 4 months for control; P: 0.0005).
  
  
  CONCLUSIONS
  To our knowledge, this retrospective analysis is the largest multicenter study to demonstrate that bone metastases from GC are not so rare, are commonly aggressive and result in relatively early onset of SREs in the majority of patients. Indeed, our large study, which included 90 patients treated with ZOL, showed, for the first time in literature, a significant extension of time to first SRE and increase in the median survival time after diagnosis of bone metastasis. Taken together, these data may support the beneficial effects of ZOL in GC patients.
authors.affiliation: Medical Oncology Unit, National Cancer Research Centre Istituto Tumori "Giovanni Paolo II", Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Silvestris
authors.forename: Francesco
authors.initials: F
authors.lastname: Pantano
authors.forename: Toni
authors.initials: T
authors.lastname: Ibrahim
authors.forename: Teresa
authors.initials: T
authors.lastname: Gamucci
authors.forename: Fernando
authors.initials: F
authors.lastname: De Vita
authors.forename: Teresa
authors.initials: T
authors.lastname: Di Palma
authors.forename: Paolo
authors.initials: P
authors.lastname: Pedrazzoli
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.forename: Antonio
authors.initials: A
authors.lastname: Bernardo
authors.forename: Antonio
authors.initials: A
authors.lastname: Febbraro
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Satolli
authors.forename: Paola
authors.initials: P
authors.lastname: Bertocchi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Catalano
authors.forename: Elisa
authors.initials: E
authors.lastname: Giommoni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Comandone
authors.forename: Evaristo
authors.initials: E
authors.lastname: Maiello
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Riccardi
authors.forename: Raimondo
authors.initials: R
authors.lastname: Ferrara
authors.forename: Antonio
authors.initials: A
authors.lastname: Trogu
authors.forename: Rossana
authors.initials: R
authors.lastname: Berardi
authors.forename: Silvana
authors.initials: S
authors.lastname: Leo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bertolini
authors.forename: Francesco
authors.initials: F
authors.lastname: Angelini
authors.forename: Saverio
authors.initials: S
authors.lastname: Cinieri
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pisconti
authors.forename: Anna Elisabetta
authors.initials: AE
authors.lastname: Brunetti
authors.forename: Amalia
authors.initials: A
authors.lastname: Azzariti
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
mesh_terms: D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000556:secondary*; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D063868:Patient Outcome Assessment; D011159:Population Surveillance; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates