Metastatic dissemination patterns of different primary tumors to the spine and other bones

Metastatic spine disease (MSD) is a severe event in cancer patients. Experimental data indicate that bone metastasis is mostly mediated by blood flow-dependent, passive arrest of circulating tumor cells to the bone metastatic niche (BMN). Here, we have set out to test these experimental observations...

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Bibliographic Details
Published in:Clinical & experimental metastasis 2019-12, Vol.36 (6), p.493-498
Main Authors: Onken, Julia S., Fekonja, Lucius S., Wehowsky, Romy, Hubertus, Vanessa, Vajkoczy, Peter
Format: Article
Language:English
Subjects:
Biomedical and Life Sciences
Biomedicine
Blood circulation
Blood flow
Bone blood flow
Bone marrow
Bone Neoplasms - blood
Bone Neoplasms - diagnostic imaging
Bone Neoplasms - secondary
Bones
Breast cancer
Cancer
Cancer Research
Data analysis
Diagnosis
Female
Follow-Up Studies
Hematology
Homing
Humans
Lung cancer
Male
Malignancy
Metastases
Metastasis
Middle Aged
Neoplasms - blood
Neoplasms - diagnostic imaging
Neoplasms - pathology
Neoplastic Cells, Circulating - pathology
Oncology
Prognosis
Prostate cancer
Research Paper
Retrospective Studies
Skeleton
Spinal Neoplasms - blood
Spinal Neoplasms - diagnostic imaging
Spinal Neoplasms - secondary
Spine
Spine (thoracic)
Surgical Oncology
Tomography, X-Ray Computed - methods
Tumor cells
Tumors
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Summary:Metastatic spine disease (MSD) is a severe event in cancer patients. Experimental data indicate that bone metastasis is mostly mediated by blood flow-dependent, passive arrest of circulating tumor cells to the bone metastatic niche (BMN). Here, we have set out to test these experimental observations in a clinical, human setting to improve our understanding of MSD. 507 patients, treated on spinal metastases in our institution from 2005 to  2015 were retrospectively evaluated. We identified 259 patients with accessible staging reports of the skeleton before and at initial diagnosis of MSD. Data analysis comprised localizations of bone metastases, underlying malignancy and time to development of MSD. Dissemination pattern of bone metastasis was correlated with red bone marrow (RBM) content of the respective bone as a measure of blood flow. Spinal metastases occurred most frequently in lung cancer (21%), prostate cancer (19%), and breast cancer (12%). At the diagnosis of MSD, majority of patients have multiple extra-spinal bone metastases (2/3). The distribution of metastases to extra-spinal bones and to the spine is mostly proportional to the RBM content of the involved bone. Corresponding to the high RBM content, thoracic spine, pelvic bones and ribs represent a predilection site for bone metastasis. We confirm a distinct preference of cancer types to metastasize to bones. When it comes to bone metastases all primaries show uniform distribution pattern, which supports the hypothesis of a predominantly blood flow-dependent distribution of tumor cells and passive arrest to the BMN rather than a spine-specific homing mechanism.
ISSN:0262-0898
1573-7276
DOI:10.1007/s10585-019-09987-w