A Retrospective Cohort of Tumor-Induced Osteomalacia and Case Series of Malignant Disease
Authors' conclusion
TIO is a condition with significant morbidity. Very high FGF23 levels and disease recurrence are associated with malignant disease. Reasons behind the observation of higher mortality in nonlocalizing TIO should be further explored.
Study context
- Population
- Patients diagnosed with tumor-induced osteomalacia (TIO) at an academic medical center, January 1998–May 2023
- Participants
- 68 patients
- Exposure
- Localizing vs nonlocalizing TIO; malignant vs nonmalignant TIO
- Localizingn = 49
- Malignantn = 5
- Outcome
- Clinical characteristics of TIO cohort
Methodological detailssingle academic medical center, with case series of malignant disease
- Single academic medical center
- With case series of malignant disease
Main finding
As reported in the abstract
- Cure among patients attempting localizing procedures (n=50)
- 29 (58%)
- Persistent disease (wrong tumor targeted, refractory or recurrent tumors) despite up to 6 procedural attempts
- 20 (40%)
- Lower extremity commonest localization site
- 37%
- Localized tumors in bone / soft tissue
- 47% / 53%
- Malignant cases located in trunk
- 60%
- Tumor size correlated with peak FGF23
- R = 0.566, P < .001
- Tumor size not associated with malignancy risk
- P = 0.479
- FGF23 >20 times upper limit of normal with normal renal function associated with malignancy
- P = 0.025
- Recurrence after initial cure associated with malignancy
- P = 0.013
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| SurvivalNonlocalizing vs Localizing · lower survival with Nonlocalizing | P = 0.0097 |
Original publication
A Retrospective Cohort of Tumor-Induced Osteomalacia and Case Series of Malignant Disease. J Clin Endocrinol Metab. Published 20 March 2024. doi:10.
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