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The presenting dental status of solid tumours with bone metastases requiring bone-targeting agents - part 3: prostate cancer

British Dental Journal (2022)Cite this article

Abstract

Introduction Metastatic prostate cancer (MPC) patients due to receive bone-targeting agents (BTAs) are expected to undertake a dental assessment before commencing. The aim of this study was to determine the dental status of this tumour group and understand the challenges the dental practitioner faces in attempting to achieve 'dental fitness'.

Materials and methods Data were retrospectively collected from a dedicated pre-BTA dental assessment clinic and analysed for MPC. Statistical analysis and observational data were used to compare patient and tumour demographics.

Results A total of 111 patients were included in this cohort, with the majority of patients presenting with only bone metastases (BM) and no additional metastatic sites. On average, MPC patients presented with 19.3 teeth and were below the threshold for functional dentition. The 75-84-year-old age group had the worst horizontal bone loss score and subsequently lose six teeth over a decade (p = 0.001). In addition, all MPC tumour sub-categories showed favourable survival rates.

Conclusion MPC patients have a high dental burden on presentation, likely associated with their age. Favourable survival prospects and the cumulation of BTAs and dental disease would suggest a heightened risk of medication-related osteonecrosis of the jaw in this group compared to many other tumour sites.

Key points

  • In prostate cancer, bone is the most dominant or sometimes the only site regarding metastases.

  • In general, metastatic prostate cancer patients have a higher survival rate than many other metastatic tumour groups.

  • Bone-targeting agents in metastatic prostate cancer may include the use of radium-223 which has been implicated in medication-related osteonecrosis of the jaw.

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Authors and Affiliations

  1. Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, London, UK

    Vinod Patel, Megan Burns, Sheelen Patel, Rana Wali & Marianne Henien

  2. Oral and Maxillofacial Surgery Department, Torbay Hospital, UK

    Sanford Grossman

  3. Computer Science Department, Brunel University, London, Kingston Lane, Uxbridge, UB8 3PH, UK

    Isabel Sassoon

  4. Medical Oncology, Guy´s and St Thomas´ NHS Foundation Trust, London, UK

    Elias Pintus

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  1. Vinod Patel
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Correspondence to Vinod Patel.

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19/LO/1600 - Dental status of oncology patients requiring bone modulating therapy - a retrospective cohort study.

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Patel, V., Burns, M., Patel, S. et al. The presenting dental status of solid tumours with bone metastases requiring bone-targeting agents - part 3: prostate cancer. Br Dent J (2022). https://doi.org/10.1038/s41415-022-3928-0

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