Natural History of Malignant Bone Disease in Gastric Cancer: Final Results of a Multicenter Bone Metastasis Survey

Nicola Silvestris, Francesco Pantano, Toni Ibrahim, Teresa Gamucci, Fernando De Vita, Teresa Di Palma, Paolo Pedrazzoli, Sandro Barni, Antonio Bernardo, Antonio Febbraro, Maria Antonietta Satolli, Paola Bertocchi, Vincenzo Catalano, Elisa Giommoni, Alessandro Comandone, Evaristo Maiello, Ferdinando Riccardi, Raimondo Ferrara, Antonio Trogu, Rossana BerardiSilvana Leo, Alessandro Bertolini, Francesco Angelini, Saverio Cinieri, Antonio Russo, Salvatore Pisconti, Anna Elisabetta Brunetti, Amalia Azzariti, Daniele Santini

Research output: Contribution to journalArticlepeer-review


Background:Bone metastasis represents an increasing clinical problem in advanced gastric cancer (GC) as disease-related survival improves. In literature, few data on the natural history of bone disease in GC are available.Patients and Methods:Data on clinicopathology, skeletal outcomes, skeletal-related events (SREs), and bone-directed therapies for 208 deceased GC patients with evidence of bone metastasis were statistically analyzed.Results:Median time to bone metastasis was 8 months (CI 95%, 6.125-9.875 months) considering all included patients. Median number of SREs/patient was one. Less than half of the patients (31%) experienced at least one and only 4 and 2% experienced at least two and three events, respectively. Median times to first and second SRE were 2 and 4 months, respectively. Median survival was 6 months after bone metastasis diagnosis and 3 months after first SRE. Median survival in patients who did not experience SREs was 5 months. Among patients who received zoledronic acid before the first SRE, the median time to appearance of first SRE was significantly prolonged compared to control (7 months vs 4 months for control; P: 0.0005).Conclusions:To our knowledge, this retrospective analysis is the largest multicenter study to demonstrate that bone metastases from GC are not so rare, are commonly aggressive and result in relatively early onset of SREs in the majority of patients. Indeed, our large study, which included 90 patients treated with ZOL, showed, for the first time in literature, a significant extension of time to first SRE and increase in the median survival time after diagnosis of bone metastasis. Taken together, these data may support the beneficial effects of ZOL in GC patients.

Original languageEnglish
Article numbere74402
JournalPLoS One
Issue number10
Publication statusPublished - Oct 28 2013

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)


Dive into the research topics of 'Natural History of Malignant Bone Disease in Gastric Cancer: Final Results of a Multicenter Bone Metastasis Survey'. Together they form a unique fingerprint.

Cite this