br SUPPLEMENTAL INFORMATION br AUTHOR CONTRIBUTIONS
CONFLICTS OF INTEREST
The authors declare no competing interests. r> ACKNOWLEDGMENTS
This work was supported by the Priority Academic Program Develop-ment of Jiangsu Higher Education Institutions (PAPD), the 2016 “333 Molecular Therapy: Nucleic Acids
Project” Award of Jiangsu Province, the 2013 “Qinglan Project” of the Young and Middle-aged Academic Leader of Jiangsu College and University, the National Natural Science Foundation of China (grants 81571055, 81400902, 81271225, 31201039, 81171012, and 30950031), the Major Fundamental Research Program of the Natural Science Foundation of the Jiangsu Higher Education Institutions of China (grant 13KJA180001), and grants from the Cultivate National Science Fund for Distinguished Young Scholars of Jiangsu Normal Univer-sity. We would like to give our sincere appreciation to the reviewers for their helpful comments on this article.
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Contents lists available at ScienceDirect
Journal of Bone Oncology
journal homepage: www.elsevier.com/locate/jbo
Bone metastasis pattern of cancer patients with bone metastasis but no T
Zhu Mingyua,1, Liu Xina,1, Qu Yuanb,1, Hu Silongb, Zhang Yingjianb, Li Wentaoa, Zhou Xiaoyana, Yang Huijuana, Zhou Liangpinga, Wang Qifenga, Hou Yifenga, Chen Yonga, Wang Yanlia, Wang Yaohuia, Lu Zhongwua, Luo Zhiguoa, , Hu Xichuna,
a Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, 270 Dongan Rd, Shanghai 200032, China
b Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, 270 Dongan Rd, Shanghai 200032, China
Positron emission tomography/computed tomography (PET/CT) Vertebral venous plexus
Background: Bone metastasis of cancer can be a result from systemic blood spreading or vertebral venous plexus spreading. Systemic blood pathway induced bone metastasis can happen in any bone in the body since the spreading is considered to be random. However, it remains unknown whether there is any pattern of vertebral venous plexus related bone metastasis. In this study, we explored bone metastasis patterns in patients whose primary tumors had been well identified.
Methods: We included 290 consecutive cancer patients with bone metastases but no visceral metastases, out of 2559 patients whose bone metastases were diagnosed by positron emission tomography/computed tomography, between Jan 2015 and Oct 2017 at the Fudan University Shanghai Cancer Center. We excluded those with visceral metastasis to ensure that our study focused on metastasis through the vertebral venous plexus. And we analyzed the distribution and pattern of skeletal metastases.
Results: Of the 290 patients, 28 had head and neck tumors, 178 had thorax tumors, 49 had abdominal tumors and 35 had pelvic tumors; 102 (35%) had only one bone containing a metastasis and 188 (65%) had multiple bones containing metastases. Overall, metastases to the thoracic skeleton were more common in patients with thorax tumors than in other patients (81% vs. 67%, P = 0.007); metastases to the cervical spine or thoracic bones were more common in patients with primary tumors above the diaphragm than those below the dia-phragm (82% vs. 66%, P = 0.002). Among those with only one bone containing a metastasis (n = 102), patients with head and neck tumors had a higher incidence of cervical spine metastasis than other patients (25% vs. 2%, P = 0.03), those with thorax tumors had a higher incidence of thoracic bone metastasis than other patients (56% vs. 35%, P = 0.035), and those with pelvic tumors had a higher incidence of pelvis bone metastasis than other patients (78% vs. 27%, P = 0.000054).