title: Natural History of Non-Small-Cell Lung Cancer with Bone Metastases.
abstract: We conducted a large, multicenter, retrospective survey aimed to explore the impact of tumor bone involvement in Non-Small Cell Lung Cancer.Data on clinical-pathology, skeletal outcomes and bone-directed therapies for 661 deceased patients with evidence of bone metastasis were collected and statistically analyzed. Bone metastases were evident at diagnosis in 57.5% of patients. In the remaining cases median time to bone metastases appearance was 9 months. Biphosphonates were administered in 59.6% of patients. Skeletal-related events were experienced by 57.7% of patients; the most common was the need for radiotherapy. Median time to first skeletal-related event was 6 months. Median survival after bone metastases diagnosis was 9.5 months and after the first skeletal-related event was 7 months. We created a score based on four factors used to predict the overall survival from the diagnosis of bone metastases: age >65 years, non-adenocarcinoma histology, ECOG Performance Status >2, concomitant presence of visceral metastases at the bone metastases diagnosis. The presence of more than two of these factors is associated with a worse prognosis.This study demonstrates that patients affected by Non-Small Cell Lung Cancer with bone metastases represent a heterogeneous population in terms of risk of skeletal events and survival.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Santini
authors.initials: S
authors.lastname: Daniele
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.affiliation: Division of Medical Oncology, Department of Oncology, Azienda Ospedaliera Treviglio, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy.
authors.forename: Barni
authors.initials: B
authors.lastname: Sandro
authors.forename: Salvatore
authors.initials: S
authors.lastname: Intagliata
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Intagliata
authors.initials: I
authors.lastname: Salvatore
authors.forename: Alfredo
authors.initials: A
authors.lastname: Falcone
authors.affiliation: Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Via Roma 67, 56126 Pisa, Italy.
authors.forename: Falcone
authors.initials: F
authors.lastname: Alfredo
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferraù
authors.affiliation: Division of Medical Oncology, S.Vincenzo Hospital, Taormina, Italy.
authors.forename: Ferraù
authors.initials: F
authors.lastname: Francesco
authors.forename: Domenico
authors.initials: D
authors.lastname: Galetta
authors.affiliation: Medical Oncology Unit, Clinical Cancer Center, Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124 Bari, Italy.
authors.forename: Galetta
authors.initials: G
authors.lastname: Domenico
authors.forename: Luca
authors.initials: L
authors.lastname: Moscetti
authors.affiliation: Department of Oncology and Hematology, 'Belcolle' Hospital, Viterbo, Italy.
authors.forename: Moscetti
authors.initials: M
authors.lastname: Luca
authors.forename: Nicla
authors.initials: N
authors.lastname: La Verde
authors.affiliation: Department of Oncology, A.O. Fatebenefratelli e Oftalmico, Corso di Porta Nuova 23, 20121, Milan, Italy.
authors.forename: La Verde
authors.initials: LV
authors.lastname: Nicla
authors.forename: Toni
authors.initials: T
authors.lastname: Ibrahim
authors.affiliation: Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Toni
authors.forename: Fausto
authors.initials: F
authors.lastname: Petrelli
authors.affiliation: Division of Medical Oncology, Department of Oncology, Azienda Ospedaliera Treviglio, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy.
authors.forename: Petrelli
authors.initials: P
authors.lastname: Fausto
authors.forename: Enrico
authors.initials: E
authors.lastname: Vasile
authors.affiliation: Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Via Roma 67, 56126 Pisa, Italy.
authors.forename: Vasile
authors.initials: V
authors.lastname: Enrico
authors.forename: Laura
authors.initials: L
authors.lastname: Ginocchi
authors.affiliation: Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Via Roma 67, 56126 Pisa, Italy.
authors.forename: Ginocchi
authors.initials: G
authors.lastname: Laura
authors.forename: Davide
authors.initials: D
authors.lastname: Ottaviani
authors.affiliation: Department of Medical Oncology, Presidio Sanitario Gradenigo, Turin, Italy.
authors.forename: Ottaviani
authors.initials: O
authors.lastname: Davide
authors.forename: Flavia
authors.initials: F
authors.lastname: Longo
authors.affiliation: Department of Molecular Medicine, University Sapienza, Rome, Italy.
authors.forename: Longo
authors.initials: L
authors.lastname: Flavia
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.affiliation: Department of Medical Oncology, Institute for Cancer Research &Treatment (IRCC), Candiolo, Torino, Italy.
authors.forename: Ortega
authors.initials: O
authors.lastname: Cinzia
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.affiliation: Department of Surgery and Oncology, Section of Medical Oncology, University of Palermo, Palermo, Italy.
authors.forename: Russo
authors.initials: R
authors.lastname: Antonio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Badalamenti
authors.affiliation: Department of Surgery and Oncology, Section of Medical Oncology, University of Palermo, Palermo, Italy.
authors.forename: Badalamenti
authors.initials: B
authors.lastname: Giuseppe
authors.forename: Elena
authors.initials: E
authors.lastname: Collovà
authors.affiliation: Medical Oncology, AO Ospedale Civile di Legnano, Italy.
authors.forename: Collovà
authors.initials: C
authors.lastname: Elena
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lanzetta
authors.affiliation: Istituto Neurotraumatologico Italiano, Unità Funzionale di Oncologia, Grottaferrata, Italy.
authors.forename: Lanzetta
authors.initials: L
authors.lastname: Gaetano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mansueto
authors.affiliation: Medical Oncology Department, General Hospital, Frosinone, Italy.
authors.forename: Mansueto
authors.initials: M
authors.lastname: Giovanni
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Adamo
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy ; Medical Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Papardo-Piemonte, Messina, Italy.
authors.forename: Adamo
authors.initials: A
authors.lastname: Vincenzo
authors.forename: Filippo
authors.initials: F
authors.lastname: De Marinis
authors.affiliation: Division of Thoracic Oncology, European Institute of Oncology (IEO), Milan, Italy.
authors.forename: De Marinis
authors.initials: de M
authors.lastname: Filippo
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Satolli
authors.forename: Flavia
authors.initials: F
authors.lastname: Cantile
authors.forename: Cantile
authors.initials: C
authors.lastname: Flavia
authors.forename: Andrea
authors.initials: A
authors.lastname: Mancuso
authors.affiliation: Department of Medical Oncology, San Camillo and Forlanini Hospitals Rome, Italy.
authors.forename: Mancuso
authors.initials: M
authors.lastname: Andrea
authors.affiliation: Department of Medical Oncology, University of Cagliari, Cagliari, Italy.
authors.forename: Francesca Maria
authors.initials: FM
authors.lastname: Tanca
authors.forename: Raffaele
authors.initials: R
authors.lastname: Addeo
authors.affiliation: U.O. Oncologia, ASL NA2 NORD, Frattamaggiore, Italy.
authors.forename: Addeo
authors.initials: A
authors.lastname: Raffaele
authors.forename: Marco
authors.initials: M
authors.lastname: Russano
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Russano
authors.initials: R
authors.lastname: Marco
authors.forename: Michelle
authors.initials: M
authors.lastname: Sterpi
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Sterpi
authors.forename: Francesco
authors.initials: F
authors.lastname: Pantano
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Pantano
authors.initials: P
authors.lastname: Francesco
authors.forename: Bruno
authors.initials: B
authors.lastname: Vincenzi
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Vincenzi
authors.initials: V
authors.lastname: Bruno
authors.affiliation: Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.forename: Tonini
authors.initials: T
authors.lastname: Giuseppe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult