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Bone Metastasis in Cervical Cancer Patients Over a 10-Year Period
  1. Duangmani Thanapprapasr, MD*,
  2. Adisak Nartthanarung, MD,
  3. Puchong Likittanasombut, MD*,
  4. Nathpong Israngura Na Ayudhya, MD*,
  5. Chuenkamon Charakorn, MD*,
  6. Umaporn Udomsubpayakul, MSc (Biostat),
  7. Thanya Subhadarbandhu, MD and
  8. Sarikapan Wilailak, MD*
  1. *Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,
  2. Department of Orthopedics, and
  3. Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  1. Address correspondence and reprint requests to Duangmani Thanapprapasr, MD, Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Rama VI Rd, Bangkok 10400, Thailand. E-mail: radtn{at}


Introduction: Cervical cancer is the major cancer burden in developing countries. Bone is the third most common site of distant metastasis after the lungs and liver. Therefore, the aims of this study were to find the incidence and clinical characteristics of bone metastasis in our hospital.

Patients and Methods: Fifty-one cervical cancer patients with bone metastasis during the period from January 1998 to December 2007 were recruited. All patients' medical records were reviewed and analyzed.

Results: Among 4620 cervical cancer patients, there were 51 patients (1.1%) who had bone metastases. Ten patients' medical records were not found; thus, 41 patients were available for evaluation. The median age of the patients was 49 years. International Federation of Gynecology and Obstetrics stage IIB was the most common stage (43.9%). Most patients had squamous cell carcinoma (80.48%) and received radiation therapy alone as their primary treatment (58.53%). The most common presenting symptom was pain (78.04%). Most of the patients had multiple bone lesions and extrapelvic bone metastases. The lumbar spine was the most common site (36.36%). Sixteen patients (39.02%) were treated by palliative radiation therapy. The median overall survival was 23 months.

Conclusions: Bone metastases could be found at all stages. Common sites were the bone beyond the radiation field of their primary treatment. It was found at a median of 16 months after cervical cancer diagnosis. Currently, there are many varieties of treatment that result only in palliation. This group of patients has a poor prognosis.

  • Bone metastasis
  • Cervical cancer

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