Systematic review of isolated disseminated carcinomatosis of bone marrow from colorectal cancer.
bone marrow failure
chemotherapy
disseminated carcinomatosis bone marrow
disseminated intravascular coagulation
metastatic colorectal cancer
Journal
ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
29
01
2023
received:
19
11
2022
accepted:
31
01
2023
medline:
26
5
2023
pubmed:
12
2
2023
entrez:
11
2
2023
Statut:
ppublish
Résumé
Colorectal cancer (CRC) metastasis commonly occurs in the liver and lungs with bone metastasis rarely occurring in isolation. Disseminated carcinomatosis of bone marrow (DCBM) is extremely rare in CRC. We conducted a systematic review to provide more information on the diagnosis, treatment options, and prognosis of the condition. Studies were identified by performing searches on MEDLINE and EMBASE electronic databases according to the PRISMA statement standards. We included a single patient whom we treated for metastatic CRC presenting with DCBM in our study. Statistical analysis was performed using SPSS software version 23.0. A search through 5502 unique studies yielded 14 studies that were eventually included. There was a total of 17 cases of DCBM in CRC with back pain and constitutional symptoms as the most common presenting complaints. DCBM in CRC was associated with markedly elevated CEA of 275.57 (95% CI 17.13-534.00). There was no predilection for site of primary tumour. Overall median survival was 120 days (95% CI 64.43-175.58). The median survival for patients who received chemotherapy was 240 days (95% CI 71.11-408.89), as compared to 9 days (95% CI 1.80-16.20) for patients who received best supportive treatment. DCBM from CRC is extremely rare. Bone marrow examination remains the gold standard for diagnosis. Colonic stenting or surgical diversion may be more appropriate than primary resection in obstructed CRC in view of the poor prognosis. Systemic chemotherapy shows promise in increasing median survival.
Sections du résumé
BACKGROUND
Colorectal cancer (CRC) metastasis commonly occurs in the liver and lungs with bone metastasis rarely occurring in isolation. Disseminated carcinomatosis of bone marrow (DCBM) is extremely rare in CRC. We conducted a systematic review to provide more information on the diagnosis, treatment options, and prognosis of the condition.
METHODS
Studies were identified by performing searches on MEDLINE and EMBASE electronic databases according to the PRISMA statement standards. We included a single patient whom we treated for metastatic CRC presenting with DCBM in our study. Statistical analysis was performed using SPSS software version 23.0.
RESULTS
A search through 5502 unique studies yielded 14 studies that were eventually included. There was a total of 17 cases of DCBM in CRC with back pain and constitutional symptoms as the most common presenting complaints. DCBM in CRC was associated with markedly elevated CEA of 275.57 (95% CI 17.13-534.00). There was no predilection for site of primary tumour. Overall median survival was 120 days (95% CI 64.43-175.58). The median survival for patients who received chemotherapy was 240 days (95% CI 71.11-408.89), as compared to 9 days (95% CI 1.80-16.20) for patients who received best supportive treatment.
CONCLUSION
DCBM from CRC is extremely rare. Bone marrow examination remains the gold standard for diagnosis. Colonic stenting or surgical diversion may be more appropriate than primary resection in obstructed CRC in view of the poor prognosis. Systemic chemotherapy shows promise in increasing median survival.
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1169-1175Informations de copyright
© 2023 Royal Australasian College of Surgeons.
Références
Katoh M, Unakami M, Hara M, Fukuchi S. Bone metastasis from colorectal cancer in autopsy cases. J. Gastroenterol. 1995; 30: 615-8.
Shinden Y, Sugimachi K, Tanaka F et al. Clinicopathological characteristics of disseminated carcinomatosis of the bone marrow in breast cancer patients. Mol. Clin. Oncol. 2018; 8: 93-8.
Yoshioka K, Shimizu H, Yokoo S, Andachi H. Disseminated carcinomatosis of bone marrow from submucosal carcinoma in adenoma of the rectum. Intern. Med. 1992; 31: 1056-9.
Huang WT, Chang KC, Shan YS, Tsao CJ, Lee JC. Successful initial treatment with weekly 24-hour infusion of 5-fluorouracil and leucovorin in a rectal cancer patient with acute disseminated intravascular coagulation. Hepatogastroenterology 2005; 52: 1436-9.
Pleyer L, Went P, Russ G et al. Massive infiltration of bone marrow in colon carcinoma after treatment with activated protein C. Wien. Klin. Wochenschr. 2007; 119: 254-8.
Misawa R, Kobayashi M, Ito M, Kato M, Uchikawa Y, Takagi S. Primary colonic signet ring cell carcinoma presenting carcinocythemia: an autopsy case. Case Rep. Gastroenterol. 2008; 2: 301-7.
Lim DH, Lee SI, Park KW. Bone marrow metastasis of colon cancer as the first site of recurrence: a case report. Oncol. Lett. 2014; 8: 2672-4. https://doi.org/10.3892/ol.2014.2581.
Naito M, Yoshida Y, Aisu N et al. A report of disseminated carcinomatosis of the bone marrow originating from transverse colon cancer successfully treated with chemotherapy using XELOX plus bevacizumab. Case Rep. Oncol. 2014; 7: 426-34.
Nakashima Y, Takeishi K, Guntani A et al. Rectal cancer with disseminated carcinomatosis of the bone marrow: report of a case. Int. Surg. 2014; 99: 518-22.
van Bunderen CC, de Weger VA, Griffioen-Keijzer A. Disseminated intravascular coagulation as clinical manifestation of colorectal cancer: a case report and review of the literature. Neth. J. Med. 2014; 72: 186-9.
Assi R, Mukherji D, Haydar A, Saroufim M, Temraz S, Shamseddine A. Metastatic colorectal cancer presenting with bone marrow metastasis: a case series and review of literature. J. Gastrointest. Oncol. 2016; 7: 284-97.
Soavi C, Parisi C, Tiseo R et al. Lumbar pain as unusual presentation of bone marrow metastatic replacement by colon carcinoma. J. Am. Geriatr. Soc. 2015; 63: 1037-8.
Hanamura F, Shibata Y, Shirakawa T et al. Favorable control of advanced colon adenocarcinoma with severe bone marrow metastasis: a case report. Mol. Clin. Oncol. 2016; 5: 579-82.
Takeyama H, Sakiyama T, Wakasa T et al. Disseminated carcinomatosis of the bone marrow with disseminated intravascular coagulation as the first symptom of recurrent rectal cancer successfully treated with chemotherapy: a case report and review of the literature. Oncol. Lett. 2017; 13: 4290-4.
O'Brien JM, Watson PJ, Proud D. Isolated bone marrow metastases of colorectal adenocarcinoma. ANZ J. Surg. 2019; 89: E519-20.
Ehara T, Kitazawa M, Hondo N et al. Treatment of rectal cancer-induced disseminated carcinomatosis of the bone marrow with FOLFOX plus cetuximab and panitumumab. Case Rep. Oncol. 2020; 13: 145-1.
Batson OV. The function of the vertebral veins and their role in the spread of metastases. Ann. Surg. 1940; 112: 138-49.
Fornetti J, Welm AL, Stewart SA. Understanding the bone in cancer metastasis. J. Bone Miner. Res. 2018; 33: 2099-113.
Baek SJ, Hur H, Min BS, Baik SH, Lee KY, Kim NK. The characteristics of bone metastasis in patients with colorectal cancer: a long-term report from a single institution. World J. Surg. 2016; 40: 982-6.
Hatoum HT, Lin SJ, Smith MR, Barghout V, Lipton A. Zoledronic acid and skeletal complications in patients with solid tumors and bone metastases: analysis of a national medical claims database. Cancer 2008; 113: 1438-45.
Aft R, Perez JR, Raje N, Hirsh V, Saad F. Could targeting bone delay cancer progression? Potential mechanisms of action of bisphosphonates. Crit. Rev. Oncol. Hematol. 2012; 82: 233-48.
Stopeck AT, Lipton A, Body JJ et al. Denosumab compared with zoledronic acid for the treatment of bone metastases in patients with advanced breast cancer: a randomized, double-blind study. J. Clin. Oncol. 2010; 28: 5132-9.