Svensson Elisabeth, Christiansen Christian F, Ulrichsen Sinna P, Rørth Mikael R, Sørensen Henrik T
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Epidemiology and Biostatistics, The Danish Clinical Registries, Aarhus, Denmark.
BMJ Open. 2017 Sep 11;7(9):e016022. doi: 10.1136/bmjopen-2017-016022.
In the 10 most common primary types with bone metastases, we aimed to examine survival, further stratifying on bone metastases only or with additional synchronous metastases.
We included all patients aged 18 years and older with incident hospital diagnosis of solid cancer between 1994 and 2010, subsequently diagnosed with BM until 2012. We followed patients from date of bone metastasis diagnosis until death, emigration or 31 December 2012, whichever came first. We computed 1-year, 3-year and 5-year survival (%) and the corresponding 95% CIs stratified on primary cancer type. Comparing patients with bone metastasis only and patients with other synchronous metastases, we estimated crude and adjusted HRs and corresponding 95% CI for mortality.
We included 17 251 patients with bone metastasis. The most common primary cancer types with bone metastasis were prostate (34%), breast (22%) and lung (20%). One-year survival after bone metastasis diagnosis was lowest in patients with lung cancer (10%, 95% CI 9% to 11%) and highest in patients with breast cancer (51%, 50% to 53%). At 5 years of follow-up, only patients with breast cancer had over 10% survival (13%, 11% to 14%). The risk of mortality was increased for the majority of cancer types among patients with bone and synchronous metastases compared with bone only (adjusted relative risk 1.29-1.57), except for cervix, ovarian and bladder cancer.
While patients with bone metastases after most primary cancers have poor survival, one of ten patients with bone metastasis from breast cancer survived 5 years.
在10种最常见的发生骨转移的原发肿瘤类型中，我们旨在研究生存率，并进一步按仅发生骨转移或同时伴有其他同步转移进行分层分析。
我们纳入了所有年龄在18岁及以上、于1994年至2010年间首次因实体癌入院诊断、随后至2012年被诊断为骨转移的患者。我们对患者从骨转移诊断日期开始进行随访，直至死亡、移民或2012年12月31日，以先发生者为准。我们计算了1年、3年和5年生存率（%）以及按原发癌类型分层的相应95%置信区间。比较仅发生骨转移的患者和伴有其他同步转移的患者，我们估计了死亡率的粗风险比和调整后风险比以及相应的95%置信区间。
我们纳入了17251例骨转移患者。发生骨转移最常见的原发癌类型是前列腺癌（34%）、乳腺癌（22%）和肺癌（20%）。骨转移诊断后的1年生存率在肺癌患者中最低（10%，95%置信区间9%至11%），在乳腺癌患者中最高（51%，50%至53%）。在5年随访时，只有乳腺癌患者的生存率超过10%（13%，11%至14%）。与仅发生骨转移的患者相比，骨转移同时伴有其他同步转移的大多数癌症类型患者的死亡风险增加（调整后相对风险1.29 - 1.57），但宫颈癌、卵巢癌和膀胱癌除外。
虽然大多数原发癌发生骨转移后的患者生存率较差，但每10例乳腺癌骨转移患者中有1例存活了5年。
