Chirurgia (2015) 110: 43-48
No. 1, January - February
Copyright© Celsius
Rezumat
Fracturi osoase la bolnavii de cancer mamar cu metastaze
osoase izolate
Scop: Sã analizãm incidenåa fracturilor osoase la pacientele cu
cancer mamar cu metastaze osoase izolate æi efectele acestora
asupra supravieåuirii. Am încercat sã gãsim un rãspuns la
întrebarea: “Putem prezice dezvoltarea fracturilor osoase?”
Metode: Între 1993-2006, 139 de paciente cu neoplazie
mamarã cu metastaze osoase izolate au fost examinate.
Pacientele au fost distribuite în douã grupuri în funcåie de
dezvoltarea de fracturi osoase pe os patologic.
Rezultate: 41 de paciente (29.5%) au dezvoltat fracturi în pânã
la 41 de luni de urmãrire. Localizãrile fracturilor pe os
patologic au fost: vertebrale la 26 de paciente (63.4%), femurale
la 11 paciente (26.8%), æi fracturã de æold la 4 paciente (9.8%).
Frecvenåa fracturilor la paciente hormon sensibile æi hormon
rezistente a fost de 31.2%, respectiv 14.3%. Rata fracturilor la
13 paciente triplu negative æi non-triplu negative a fost de
7.7%, respectiv 31.4%, (p=0.07). Valori crescute ale CA 15-3
la momentul apariåiei metastazelor la pacientele cu æi fãrã
fracturi au apãrut în proporåii de 68.4%, respectiv 61.1%.
Riscul de fracturã a fost de asemenea mai crescut la pacientele
Her2-neu pozitive (38.7% vs. 26.5%). În timp ce incidenåa
fracturilor în asociere cu unul din factorii menåionaåi mai sus a
fost de 22.2%, aceasta a crescut la 36.1% în prezenåa a doi sau
3 factori (p=0.13). Supravieåuirea medie a pacientelor cu æi fãrã
fracturi a fost de 48, respectiv 39 de luni (p= 0.65).
Concluzie: Sensibilitatea hormonalã, nivelul crescut de CA
15-3 æi statusul Her2-neu pozitiv sunt factori de risc slab
pentru apariåia fracturile osoase. Supravieåuirea nu a fost
diferitã la pacientele cu fracturi osoase faåã de cele fãrã.
Cuvinte cheie: cancer mamar, fracturã osoasã, metastaze osoase,
evenimente scheletale, supravieåuirec
Abstract
Aim: To analyse the incidence of bone fracture of breast
cancer patients with isolated bone metastasis and its effect
on survival. We tried to find an answer to the question of
“Can the development of bone fracture be predicted?”
Methods: Between 1993-2006, 139 breast cancer patients
with isolated bone metastasis were examined. Patients were
divided into two groups depending on the development of
pathologic bone fracture.
Results: Fractures were developed in 41 patients (29.5%)
within 41 months of follow-up. The locations of pathologic
bone fracture were vertebral fracture in 26 patients (63.4%),
femur fracture in 11 patients (26.8%), and hip fracture in
four patients (9.8%). Fracture rates in hormone sensitive and
resistant patients were 31.2% and 14.3%, respectively. The
fracture rates in 13 triple negative and non triple negative
patients were 7.7% and 31.4%, respectively (p=0.07). High
CA 15-3 levels at the time of metastasis in patients with and
without fractures were 68.4% and 61.1%, respectively. The
risk for fracture was also high in Her2-neu positive patients
Bone Fracture in Breast Cancer Patients with Isolated Bone Metastasis*
C. Dibekoglu
1
, S. Turanli
2
, N. Karaman
2
, K. Caglar Ozcelik
3
, O. Erdogan
2
1
Department of General Surgery, Istanbul Florence Nightingale Hospital, Sisli, Istanbul, Turkey
2
Department of General Surgery, Ankara Oncology Education and Research Hospital, Ankara, Turkey
3
Department of General Surgery, Kazan Government Hospital, Ankara, Turkey
Corresponding author: Sevim Turanli, MD
Ankara Oncology Education and Research
Hospital, Department of General Surgery
06200 Ankara/Turkey
E-mail: turanlisevim@hotmail.com
*This article was presented in European Society for Surgical Research 2013