Abstract: Bone metabolic disruption that occurs in bone metastatic prostate cancer could lead to disturbances of calcium metabolism. The prognostic role of either hypocalcemia or hypercalcemia was assessed in a consecutive series of hormone-refractory bone metastatic prostate cancer patients. Serum calcium was measured in 192 patients. The presence of hypocalcemia and hypercalcemia was related with baseline biochemical and clinical characteristics and the role of these two calcium disturbances in predicting prognosis and adverse skeletal-related events (SREs) was assessed. As compared to normocalcemic patients, hypocalcemic patients (n = 51) had higher tumor load in bone (P = 0.005), higher plasma chromogranin A (CgA, P = 0.01), serum alkaline phosphatase (P = 0.01), urinary N-telopeptide (NTX, P = 0.002) and lower hemoglobin values (P = 0.01), while hypercalcemic patients (n=16) had higher plasma CgA (P = 0.001) and serum lactate dehydrogenase values (P = 0.001), higher bone pain (P = 0.003) and a lower frequency of pure osteoblastic lesions (P = 0.001). Hypercalcemia was significantly associated with poor prognosis: hazard ratio (HR), 1.9 (95% confidence Interval (CI) 1.2-3.3) and higher risk to develop SREs HR, 2.5 (95% CI 1.2-5.2, P=0.01), while hypocalcemia was not associated with poor prognosis. The prognostic role of hypercalcemia was maintained in multivariate analysis after adjusting for validated prognostic parameters: HR, 2.72 (95% CI 1.1-6.8, P = 0.03). These data suggest that serum calcium levels should be taken into account in the clinical decision-making process of bone metastatic prostate cancer patients. Patients with asymptomatic hypercalcemia could benefit of a strict follow-up and an immediate bisphosphonate treatment. Further prospective clinical trials are needed to confirm this finding

Prognostic significance of disordered calcium metabolism in hormone-refractory prostate cancer patients with metastatic bone disease

PORPIGLIA, Francesco;TERZOLO, Massimo;CRACCO, CECILIA MARIA;TAMPELLINI, MARCO;REIMONDO, Giuseppe Matteo;SCARPA, Roberto Mario;ANGELI, Alberto;DOGLIOTTI, Luigi;BERRUTI, Alfredo
2009

Abstract

Abstract: Bone metabolic disruption that occurs in bone metastatic prostate cancer could lead to disturbances of calcium metabolism. The prognostic role of either hypocalcemia or hypercalcemia was assessed in a consecutive series of hormone-refractory bone metastatic prostate cancer patients. Serum calcium was measured in 192 patients. The presence of hypocalcemia and hypercalcemia was related with baseline biochemical and clinical characteristics and the role of these two calcium disturbances in predicting prognosis and adverse skeletal-related events (SREs) was assessed. As compared to normocalcemic patients, hypocalcemic patients (n = 51) had higher tumor load in bone (P = 0.005), higher plasma chromogranin A (CgA, P = 0.01), serum alkaline phosphatase (P = 0.01), urinary N-telopeptide (NTX, P = 0.002) and lower hemoglobin values (P = 0.01), while hypercalcemic patients (n=16) had higher plasma CgA (P = 0.001) and serum lactate dehydrogenase values (P = 0.001), higher bone pain (P = 0.003) and a lower frequency of pure osteoblastic lesions (P = 0.001). Hypercalcemia was significantly associated with poor prognosis: hazard ratio (HR), 1.9 (95% confidence Interval (CI) 1.2-3.3) and higher risk to develop SREs HR, 2.5 (95% CI 1.2-5.2, P=0.01), while hypocalcemia was not associated with poor prognosis. The prognostic role of hypercalcemia was maintained in multivariate analysis after adjusting for validated prognostic parameters: HR, 2.72 (95% CI 1.1-6.8, P = 0.03). These data suggest that serum calcium levels should be taken into account in the clinical decision-making process of bone metastatic prostate cancer patients. Patients with asymptomatic hypercalcemia could benefit of a strict follow-up and an immediate bisphosphonate treatment. Further prospective clinical trials are needed to confirm this finding
12
1
94
99
Tucci M; Mosca A; Lamanna G; Porpiglia F; Terzolo M; Vana F; Cracco C; Russo L; Gorzegno G; Tampellini M; Torta M; Reimondo G; Poggio M; Scarpa RM; Angeli A; Dogliotti L; Berruti A.
File in questo prodotto:
File Dimensione Formato  
Prostate Cancer Tucci et al 2009.pdf

Accesso aperto

Tipo di file: POSTPRINT (VERSIONE FINALE DELL’AUTORE)
Dimensione 105.29 kB
Formato Adobe PDF
105.29 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/131973
Citazioni
  • ???jsp.display-item.citation.pmc??? 12
  • Scopus 34
  • ???jsp.display-item.citation.isi??? 30
social impact