title: Natural history of malignant bone disease in renal cancer: final results of an Italian bone metastasis survey.
abstract: BACKGROUND
  Bone metastasis represents an increasing clinical problem in advanced renal cell carcinoma (RCC) as disease-related survival improves. There are few data on the natural history of bone disease in RCC.
  
  
  METHODS
  Data on clinicopathology, survival, skeletal-related events (SREs), and bone-directed therapies for 398 deceased RCC patients (286 male, 112 female) with evidence of bone metastasis were statistically analyzed.
  
  
  RESULTS
  Median time to bone metastasis was 25 months for patients without bone metastasis at diagnosis. Median time to diagnosis of bone metastasis by MSKCC risk was 24 months for good, 5 months for intermediate, and 0 months for poor risk. Median number of SREs/patient was one, and 71% of patients experienced at least one SRE. Median times to first, second, and third SRE were 2, 5, and 12 months, respectively. Median survival was 12 months after bone metastasis diagnosis and 10 months after first SRE. Among 181 patients who received zoledronic acid (ZOL), median time to first SRE was significantly prolonged versus control (n = 186) (3 months vs 1 month for control; P<0.05).
  
  
  CONCLUSIONS
  RCC patients with bone metastasis are at continuous risk of SREs, and in this survey ZOL effectively reduced this risk.
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.affiliation: Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
authors.affiliation: Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Camillo
authors.initials: C
authors.lastname: Porta
authors.affiliation: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)- IRCCS, Osteoncology and Rare Tumors Center, Meldola, Italy.
authors.forename: Toni
authors.initials: T
authors.lastname: Ibrahim
authors.affiliation: Treviglio and Caravaggio Hospital, Division of Medical Oncology, Treviglio, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Calogero
authors.initials: C
authors.lastname: Mazzara
authors.affiliation: Division of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fontana
authors.affiliation: Medical Oncology, Department of Clinical and Biological Sciences, A.O.U. San Luigi Gonzaga, Orbassano, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berruti
authors.affiliation: Clinica di Oncologia Medica, A. O. Ospedali Riuniti-Universitá Politecnica delle Marche, Ancona, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Berardi
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vincenzi
authors.affiliation: Ospedale Mauriziano Umberto I di Torino e Istituto Per La Ricerca e La Cura del Cancro di Candiolo, Torino, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.affiliation: Department of Medical Oncology, Presidio Sanitario Gradenigo, Turin, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Ottaviani
authors.affiliation: Azienda Ospedaliero di Rilievo Nazionale A. Cardarelli, Naples, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Carteni
authors.affiliation: INI, Grottaferrata, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lanzetta
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Virzì
authors.affiliation: Medical Oncology Unit - University of Ancona, Ancona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.affiliation: Medical Oncology Unit - IRCCS National Cancer Institute "Giovanni Paolo II", Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Silvestris
authors.affiliation: S.C. Oncologia Medica 1, C.O.E.S. - Centro Oncologico ed Ematologico Subalpino, Azienda Ospedaliero Universitaria San Giovanni Battista di Torino, Molinette, Italy.
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Satolli
authors.affiliation: Division of Medical Oncology, Hospital of Legnano, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Collovà
authors.affiliation: Section of Medical Oncology, Department of Surgery and Oncology, University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.affiliation: Section of Medical Oncology, Department of Surgery and Oncology, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Badalamenti
authors.affiliation: U.O.C. Oncologia, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Presidio San Salvatore, Pesaro, Italy.
authors.forename: Stefano Luzi
authors.initials: SL
authors.lastname: Fedeli
authors.affiliation: Department of Medical Oncology, University of Cagliari, Cagliari, Italy.
authors.forename: Francesca Maria
authors.initials: FM
authors.lastname: Tanca
authors.affiliation: Unit Integrated Therapies in Oncology, Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Adamo
authors.affiliation: Oncology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Evaristo
authors.initials: E
authors.lastname: Maiello
authors.affiliation: Divisione di Oncologia, Dipartimento Integrato di Oncologia ed Ematologia, Università degli Studi di Modena e Reggio Emilia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sabbatini
authors.affiliation: Department of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Felici
authors.affiliation: Medical Oncology Department & Breast Unit - Hospital of Brindisi and Medical Oncology Department - European Institute of Oncology, Milan, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Cinieri
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.affiliation: Department of Oncology, USL-8, Ospedale San Donato, Arezzo, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bracarda
mesh_terms: D001859:Bone Neoplasms / Q000453:epidemiology / Q000556:secondary*; D004164:Diphosphonates / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies
chemical_list: D004164:Diphosphonates