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Research article
Guilhem Roubaud
Institut Bergonie
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Prostate cancer (PCa) is associated with high skeletal morbidity especially vertebral compression fractures (VCF) occurring on bone loss. We aimed to characterize benign (bVCF) versus malignant VCF (mVCF), in PCa patients who underwent vertebroplasty, and describe respective populations.
Methods: An observational retrospective study was conducted in two French cancer centers. Characterization of VCF was made using a composite criterion (bone scan, CT scan, MRI +/- bone biopsy).
Results: From 2008 to 2016, 100 patients, mean age 73.5 (45-94) and 128 VCFs were reported: 66 (52%) mVCF and 62 (48%) bVCF. Among bVCF, 17 (27%) occured in bone metastatic patients. Among mVCF, 28 (42%) of bone metastases were purely osteolytic and 38 (58%) with osteolytic component. Regarding bVCF, continuous androgen deprivation therapy and high doses of corticosteroids (> 6 months, ≥7.5 mg/day prednisone equivalent) were given in respectively 85% and 24% of cases. Dual X-ray Absorptiometry was performed in 13% of pts. Vitamin D supplementation was prescribed in 38% of patients.
Conclusion: These data suggest the necessary prevention of bVCF even in patients with bone metastases with consequences on patient management, while studies for bone targeted agents approval used skeletal related events with no definition of the cause, i.e. benign or malignant. Occurrence of bVCF is a rising concern since these pts are experiencing longer survival. Malignant VCF were mostly with osteolytic component, which constitutes one feature of rising dedifferentiated phenotype. Vertebroplasty may play a major role in these newly defined populations.
Keywords
prostate cancer, bone, osteoporosis, skeletal related events, vertebral compression fracture
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Guilhem Roubaud
Institut Bergonie
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 21 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Prostate cancer (PCa) is associated with high skeletal morbidity especially vertebral compression fractures (VCF) occurring on bone loss. We aimed to characterize benign (bVCF) versus malignant VCF (mVCF), in PCa patients who underwent vertebroplasty, and describe respective populations.
Methods: An observational retrospective study was conducted in two French cancer centers. Characterization of VCF was made using a composite criterion (bone scan, CT scan, MRI +/- bone biopsy).
Results: From 2008 to 2016, 100 patients, mean age 73.5 (45-94) and 128 VCFs were reported: 66 (52%) mVCF and 62 (48%) bVCF. Among bVCF, 17 (27%) occured in bone metastatic patients. Among mVCF, 28 (42%) of bone metastases were purely osteolytic and 38 (58%) with osteolytic component. Regarding bVCF, continuous androgen deprivation therapy and high doses of corticosteroids (> 6 months, ≥7.5 mg/day prednisone equivalent) were given in respectively 85% and 24% of cases. Dual X-ray Absorptiometry was performed in 13% of pts. Vitamin D supplementation was prescribed in 38% of patients.
Conclusion: These data suggest the necessary prevention of bVCF even in patients with bone metastases with consequences on patient management, while studies for bone targeted agents approval used skeletal related events with no definition of the cause, i.e. benign or malignant. Occurrence of bVCF is a rising concern since these pts are experiencing longer survival. Malignant VCF were mostly with osteolytic component, which constitutes one feature of rising dedifferentiated phenotype. Vertebroplasty may play a major role in these newly defined populations.
Figure 1
Figure 2
This preprint is available for download as a PDF.
This is a list of supplementary files associated with this preprint. Click to download.
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