Epidemiology Department, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Prostate Cancer Prostatic Dis. 2011 Jun;14(2):177-83. doi: 10.1038/pcan.2011.7. Epub 2011 Mar 15.
Information on the impact of bone metastasis and skeletal-related events (SREs) on mortality among prostate cancer patients is limited. Using the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database, we identified men aged 65 years or older diagnosed with prostate cancer between July 1 1999 and December 31 2005 and followed to determine deaths through December 31 2006. We classified subjects as having bone metastasis and SREs as indicated by Medicare claims. Using Cox regression, we estimated mortality hazards ratios (HR) among men with bone metastasis with or without SRE, compared with men without bone metastasis. Among 126,978 men with prostate cancer (median follow-up, 3.3 years), 9746 (7.7%) had bone metastasis at prostate cancer diagnosis (1.7%) or during follow-up (5.9%). SREs occurred in 4296 (44%) men with bone metastasis. HRs for risk of death were 6.6 (95% CI=6.4-6.9) and 10.2 (95% CI=9.8-10.7), respectively, for men with bone metastasis but no SRE and for men with bone metastasis plus SRE, compared with men without bone metastasis. Bone metastasis was associated with mortality among prostate cancer patients. This association appeared to be stronger for bone metastasis plus SRE than for bone metastasis without SRE.
有关前列腺癌患者骨转移和骨骼相关事件（SREs）对死亡率影响的信息有限。我们利用链接的监测、流行病学和最终结果（SEER）-医疗保险数据库，确定了 1999 年 7 月 1 日至 2005 年 12 月 31 日期间年龄在 65 岁或以上被诊断患有前列腺癌的男性，并进行随访以确定截至 2006 年 12 月 31 日的死亡情况。我们根据医疗保险索赔将受试者分类为有骨转移和 SRE。使用 Cox 回归，我们估计了有或没有 SRE 的骨转移男性与没有骨转移男性的死亡率风险比（HR）。在 126978 名患有前列腺癌的男性（中位随访 3.3 年）中，有 9746 名（7.7%）在前列腺癌诊断时（1.7%）或随访期间（5.9%）有骨转移。有 4296 名（44%）骨转移男性发生了 SRE。与没有骨转移的男性相比，有骨转移但无 SRE 的男性和有骨转移加 SRE 的男性的死亡风险 HR 分别为 6.6（95%CI=6.4-6.9）和 10.2（95%CI=9.8-10.7）。骨转移与前列腺癌患者的死亡率有关。对于有骨转移加 SRE 的患者，这种相关性似乎比没有 SRE 的骨转移患者更强。
