N.N. Semenov, N.V. Lyubimova, N.E. Kushlinskii, M.R. Lichinitcer

There is a relationship between the rate of osteolysis and skeletal complications in metastatic bone disease. Hereby it is of interest to study the prognostic value of biochemical marker of osteolysis C-telopeptide of type I collagen (СТх), which is excreted with urine during the bone matrix destruction. The study included 102 patients with breast cancer bone metastases, which have assessed СТх in urine normalized to the level of urinary creatinine. The cut-off between normal and elevated osteolysis rate was selected as 0,5 mmol/mmol creatinine. It was shown that the increased osteolysis was observed in 46 patients (45 %). In these patients, the median time to development of the first skeletal-related events (pathological fracture, radiation therapy) was 12 weeks and was not achieved for patients with normal СТх in urine (p = 0,0002). Skeletal events were noted in 78,3 % vs. 57,1 % of patients, respectively (p = 0,03). The frequency of pathological fractures was significantly higher (p = 0,02) in patients with increased osteolysis (52,2 %) compare to patients with normal СТх excretion (28,6 %). The appointment of radiation therapy was in 73,9 % vs. 41,1 %, respectively (p = 0,001). Also elevated osteolysis was associated with reduced overall survival from 76 months to 25 months (p = 0,004). СТх in urine reflects the rate of osteolysis and prognosis of breast cancer bone metastases.

 

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