Main Article Content

Abstract

Objective: To take stock of fifteen years of radionuclide bone exploration in cancers in order to have scintigraphic features and prognosis of bone metastases in our setting.


Patients and Methods: It was a 15-year retrospective and descriptive study with 1278 patients who performed each a radionuclide bone scan for different types of cancers, from 2004 to 2019.  All 99mTc-MDP whole-body bone scans were realized on the same Siemens® gamma camera with a low energy high-resolution collimator. The data collected from files were analyzed using SPSS IBM® 21.0 software with a significant p-value <0.05.


Results: The age of our patients ranged from 15 to 92 years with a mean age of 55.9 years and a 1.34 sex ratio. The most represented age group was 50 to 70 years (39.36%). The most explored cancers in our study were prostate (49.68%), breast (31.77%) and cervix cancers (5.16%). The average duration since the diagnosis of the cancer was 25.7 months. Positive bone scans accounted for 40.77% and the presence of bone metastases revealed an unknown cancer in 9.79%. The preferential affected areas were the chest (79,27%), the spine (78,31%) and the pelvis (71,01%). In 26.49% of positive cases, there was no clinical sign of bone metastasis. According to the EOD and SWOG’s classification, the prognosis was poor in 70.06% and 66.22%. Prostate cancer was the most pejorative and the cervix cancer was the one with the best prognosis (p=0.0014).


Conclusions: The most explored cancers are prostate, breast and cervix cancers. The metastases are present in almost half of the cases, even in the absence of clinical signs. The axial bones, mainly in chest, spine and pelvis, are the preferential sites of metastatic lesions. Ten percent of cancers are revealed by bone metastases. In 2/3 of cases, the prognosis was pejorative. We therefore recommend that clinicians become more aware of the systematic search of bone extension as soon as the cancer is diagnosed, before the appearance of clinical signs.

Keywords

Scintigraphic features, Scintigraphic prognosis, Bone metastases, Cancers, Cameroon

Article Details

How to Cite
jfn, & NWATSOCK, J. F. (2021). Français Features and scintigraphic prognosis of bone metastases in cancer context in Cameroon: lessons learned from 15-year of radionuclide scan at Nuclear medicine department of the Yaounde General Hospital. Journal Africain d’Imagerie Médicale (J Afr Imag Méd)., 13(1). https://doi.org/10.55715/jaim.v13i1.152

References

  1. 1. Poirier J, Ribadeau D. Histologie. 6e Éd Masson, Paris 1994:67-82.
  2. 2. Cvitkovic F, Mouret-Fourme E. Épidémiologie et aspects cliniques des métastases osseuses. Bull Cancer 2013;100(11):1073-81.
  3. 3. Ukwenya AY, Yusufu LM, Nmadu PT, Garba ES, Ahmed A. Delayed treatment of symptomatic breast cancer: the experience from Kaduna, Nigeria. S Afr J Surg 2008;46:106-10.
  4. 4. Citrin DL, Bessent RG, Greig WR. A comparison of the sensitivity and accuracy of the 99m-Tc-phosphate bone scan and skeletal radiography in the diagnosis of bone metastases. Clin Radiol 1977;28(1):107-17.
  5. 5. Siegler B, Kirchner P. Nuclear medicine:Self-study programm. Éd Chapman & Hall medical company,1988.
  6. 6. Dong à Zok F, Obama S, Nko’o-Amvene S, Gonsu FJ. Introduction de la medecine nucleaire in vivo au Cameroun. J Afr Imag Med 2004;6(1):404-8.
  7. 7. Dong à Zok F, Mbodj M, Assiga Ahanda YM, Angwafor F. Apport de la médecine nucléaire dans la prise en charge du cancer de la prostate : analyse de 360 cas en milieu camerounais. Méd Nucl 2009;33(10):615-8.
  8. 8. Nwatsock JF, Atenguena-Okobalemba E, Wanko RSC, Dong-À-Zok. Profil évolutif des images scintigraphiques osseuses dans le cancer de la prostate à Yaoundé : étude pilote à propos de 31 patients. J Afr Imag Méd 2018;10(2):93-9.
  9. 9. Soloway MS, Hardeman SW, Hickey D, Raidmond J, Soloway S, Moiniddin M. Stratification of patients with metastatic prostate cancer based on extent of disease on initial bone scan. Cancer 1988;61(1):195-202.
  10. 10. Dorff TB, Tangen CM, Crawford ED, Petrylak DP, Higano CS, Raghavan D et al. Cooperative group trials – Southwest Oncology Group (SWOG) innovations in advanced prostate cancer. Ther Adv Med Oncol 2009;1(2):69–77.
  11. 11. Yomi J, Tagni D, Monkam G, Akono Zeh N, Doh A. Apport de la radiothérapie dans le traitement des cancers du sein à Yaoundé après 4 années de recul. Médecine d'Afrique Noire 1996;43(4):220-5.
  12. 12. Angwafo FF, Sosso MA, Edzoa T. Diagnosis of carcinoma of the prostate in Yaounde: the importance of prostatic biopsy. Af J Urol 1995;1:197-202.
  13. 13. Conroy T, Malissard L, Dartois D, Luporsi E, Stines J, Chardot C. Histoire naturelle et évolution des métastases osseuses. À propos de 429 observations. Bull Cancer 1988;75(9):845–57.
  14. 14. Granier P. La scintigraphie osseuse en cancérologie. Esper Med 1997;3-4.
  15. 15. Duparc J. Le traitement chirurgical des métastases osseuses des membres. Cahiers d’enseignement de SOFCOT 1983;18:5-30.
  16. 16. Durandeau A, Geneste R. Traitement chirurgical des fractures métastatiques des os long. Rev Chir Orthop 1977;63:501-17.
  17. 17. Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 2006;12:6243s-9s.
  18. 18. Wagner G. Frequency of pain in patients with cancer: Recent Results. Cancer Res 1984;89:64-71.
  19. 19. Holmes FF, Fouts TL. Metastatic cancer of unknown primary site. Cancer 1970;26:816-20.
  20. 20. Muir C. Cancer of unknown primary site. Cancer 1995;75:353-6.
  21. 21. Grosbach AB. Carcinoma of unknown primary site: a clinical enigma. Arch Int Med 1982;142:357-9.
  22. 22. Chybowsky FM, Keller JJ, Bergstralh EJ, Oesterling JE. Predicting radionuclear bone scan findings in patient with newly diagnosed untreated prostate cancer. J urol 199;145(2):313-8.
  23. 23. Kakhki VR, Anvari K, Sadeghi R, Mahmoudian AS, Torabian-Kakhki M. Pattern and distribution of bone metastases in common malignant tumors. Nucl Med Rev Cent East Eur 2013;16(2):66-9.
  24. 24. Ndong B, Mbodj M, Mbaye G, Ndoye O, Barthily E, Diouf L et al. Place de la scintigraphie osseuse dans le bilan d’extension des métastases des cancers de la prostate au Sénégal: étude préliminaire à propos de 45 cas. Med Nucl 2012;36:586-90.
  25. 25. Tofe AJ, Francis MA, Harvey WJ. Correlation of neoplasms with incidence and localisation of skeletal metastases: an analysis of 1355 diphosphonate bone scans. J Nucl Med 1975;16:986-90.