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Bone marrow examination in small cell lung cancer--when is it indicated?
J Feliu1, M González Barón, A Artal
1Department of Medical Oncology, Hospital La Paz, Madrid, Spain.
Acta Oncologica (Stockholm, Sweden)
|January 1, 1991
Summary
Bone marrow examination in small cell lung cancer (SCLC) staging is useful when other metastatic sites are unknown. It identified disease in 17% of patients, sometimes as the only metastatic site, impacting staging in 9%.
Area of Science:
- Oncology
- Pulmonology
- Pathology
Background:
- Small cell lung cancer (SCLC) is an aggressive malignancy.
- Accurate staging is crucial for treatment planning in SCLC.
- The role of bone marrow (BM) examination in SCLC staging requires evaluation.
Purpose of the Study:
- To determine the diagnostic utility of bone marrow examination in the staging of SCLC.
- To assess the impact of BM involvement on patient staging and prognosis.
Main Methods:
- Retrospective analysis of 137 SCLC patients.
- Inclusion of bone marrow biopsy results in the initial staging workup.
- Correlation of BM findings with other metastatic sites and patient outcomes.
Main Results:
- Bone marrow infiltration was found in 17% of SCLC patients at diagnosis.
- In 22% of positive cases, BM was the sole metastatic site.
- BM examination altered the stage in 9% of patients initially classified with limited disease.
- BM involvement correlated with increased bone and liver metastasis.
- No correlation was found between BM status and blood/serum biochemistry or post-chemotherapy toxicity.
- BM-positive patients had survival rates similar to extensive disease patients without BM infiltration.
Conclusions:
- Bone marrow examination is valuable in SCLC staging, particularly when other metastatic sites are not identified.
- The procedure should be reserved for cases where complete staging does not reveal other metastatic sites.
- BM status influences staging but does not independently alter prognosis compared to other extensive disease markers.