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Thirty-six patients- 65.5%- had multiple skeletal lesions and nineteen patients -34.5%- one bone lesion, independently of the visceral metastatic status.
In conclusion, in the presence of multiple skeletal lesions in patients on dialysis, MFSTB should be considered in the differential diagnosis.
Cartilage degradation was not elevated parallel to high bone resorption levels until at a late stage in the pathology of the cancer invasion involving multiple skeletal lesions.
The number of bone metastases, independent of visceral involvement status, does not reach significativity for survival in univariate analysis: the group of 19 patients with one bone lesion experienced a median survival of 9.7 months versus 7.6 months for those with multiple skeletal lesions (p =0.11).
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An analysis of the first appearance of skeletal metastasis in breast cancer patients revealed that patients with a solitary metastasis to bone (solitary bone lesion) had a better prognosis than those with multiple skeletal metastases (multiple bone lesions) [ 14].
PET-CT scan showed no recurrent lesion other than multiple skeletal muscles.
Katagiri et al. reported five prognostic factors discriminant for survival, namely, site of primary lesion, performans status, presence of visceral or cerebral metastasis and multiple skeletal metastases [ 16].
The corresponding multiple analysis revealed that older age (HR 1.4), generalized metastases (HR 2.4), and multiple skeletal metastases (HR 2.3) were significantly associated with an increased risk of death, while patients with lesions in the humerus (HR 0.7) had a significantly lower death rate (Table 3).
Simple Cox regression analysis revealed an increased risk of death after surgery for patients with lesions in the femur (HR 1.3), pathological fractures (HR 1.3), generalized metastases (HR 2.1), and multiple skeletal metastases (2.2).
We identified six significant prognostic factors for survival, namely, the primary lesion, visceral or cerebral metastases, abnormal laboratory data, poor performance status, previous chemotherapy, and multiple skeletal metastases.
AL amyloidosis can be classified as either primary amyloidosis or secondary to multiple myeloma, on the basis of the number of plasma cells in the bone marrow and/or the presence or absence of skeletal lesions that frequently involve the kidneys [ 15].
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