Pretreatment serum C-reactive protein is a significant prognostic factor in patients with soft tissue metastases.


Journal

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
ISSN: 1436-2023
Titre abrégé: J Orthop Sci
Pays: Japan
ID NLM: 9604934

Informations de publication

Date de publication:
May 2021
Historique:
received: 16 03 2020
revised: 22 04 2020
accepted: 23 04 2020
pubmed: 22 6 2020
medline: 30 9 2021
entrez: 22 6 2020
Statut: ppublish

Résumé

Soft tissue metastasis is rarer than bone metastasis. Patients with soft tissue metastasis generally have a dismal prognosis. The treatment for metastatic lesions is sometimes difficult, because the prognostic factors of patients with soft tissue metastasis remain unelucidated. Therefore, this study aimed to identify these prognostic factors. Thirty-one patients with soft tissue metastasis were included in the study. We evaluated associations of overall survival with clinical parameters and inflammatory markers using Kaplan-Meier curves and Cox proportional hazards models. Twelve patients received surgery for soft tissue metastasis, while radiation therapy was performed in six cases. The median overall survival after the detection of soft tissue metastasis was 11 months. Univariate analysis revealed that detection of soft tissue metastasis after the multidisciplinary treatment (P = 0.01); solitary metastasis (P = 0.0003); and pretreatment C-reactive protein (CRP) level < 0.4 mg/dL (P < 0.0001), white blood cell count < 8500 × 10 CRP is potentially useful for determining the indication of radical metastasectomy in soft tissue metastasis.

Sections du résumé

BACKGROUND BACKGROUND
Soft tissue metastasis is rarer than bone metastasis. Patients with soft tissue metastasis generally have a dismal prognosis. The treatment for metastatic lesions is sometimes difficult, because the prognostic factors of patients with soft tissue metastasis remain unelucidated. Therefore, this study aimed to identify these prognostic factors.
METHODS METHODS
Thirty-one patients with soft tissue metastasis were included in the study. We evaluated associations of overall survival with clinical parameters and inflammatory markers using Kaplan-Meier curves and Cox proportional hazards models.
RESULTS RESULTS
Twelve patients received surgery for soft tissue metastasis, while radiation therapy was performed in six cases. The median overall survival after the detection of soft tissue metastasis was 11 months. Univariate analysis revealed that detection of soft tissue metastasis after the multidisciplinary treatment (P = 0.01); solitary metastasis (P = 0.0003); and pretreatment C-reactive protein (CRP) level < 0.4 mg/dL (P < 0.0001), white blood cell count < 8500 × 10
CONCLUSIONS CONCLUSIONS
CRP is potentially useful for determining the indication of radical metastasectomy in soft tissue metastasis.

Identifiants

pubmed: 32563544
pii: S0949-2658(20)30137-8
doi: 10.1016/j.jos.2020.04.017
pii:
doi:

Substances chimiques

C-Reactive Protein 9007-41-4

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

478-482

Informations de copyright

Copyright © 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors declare that there are no conflicts of interest relevant to this manuscript.

Auteurs

Yuki Ishibashi (Y)

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Hiroshi Kobayashi (H)

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. Electronic address: hkobayashi-tky@umin.ac.jp.

Ryoko Sawada (R)

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Tomotake Okuma (T)

Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.

Koichi Okajima (K)

Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.

Liuzhe Zhang (L)

Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Japan.

Toshihide Hirai (T)

Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.

Takahiro Ohki (T)

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Masachika Ikegami (M)

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Yusuke Shinoda (Y)

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Toru Akiyama (T)

Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Japan.

Takahiro Goto (T)

Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.

Sakae Tanaka (S)

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

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