Tominaga Hiroyuki, Setoguchi Takao, Shimada Hirofumi, Nagano Satoshi, Sasaki Hiromi, Ishidou Yasuhiro, Sato Masami, Mizuno Keiko, Inoue Hiromasa, Komiya Setsuro
Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima 890-8520, Japan.
The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima 890-8520, Japan.
Mol Clin Oncol. 2017 Nov;7(5):897-902. doi: 10.3892/mco.2017.1394. Epub 2017 Aug 25.
The aim of the present study was to detect prognostic factors in patients with skeletal-related events (SREs) and bone metastasis at the time of non-small-cell lung cancer (NSCLC) diagnosis. A total of 85 NSCLC patients were retrospectively enrolled, 47 (55.2%) of whom presented with SREs at the time of NSCLC diagnosis. Multivariate logistic regression analysis identified squamous cell carcinoma as a risk factor for SRE. Kaplan-Meier analysis demonstrated that there was no difference in the overall survival between the SRE and no SRE groups. Cox hazard model revealed that a higher Eastern Cooperative Oncology Group (ECOG) performance status (PS) score was a risk factor for poor prognosis, while surgery for bone metastasis and molecular-targeted therapy were factors for better prognosis in patients with SREs at the time of NSCLC diagnosis. Multivariate analysis revealed that a higher ECOG PS score and metastasis to the adrenal gland were risk factors for poor prognosis, while surgery for bone metastasis and molecular-targeted therapy were factors for better prognosis. Thus, while surgical treatment and molecular-targeted therapy appear to improve the prognosis of patients with bone metastasis at the time of NSCLC diagnosis, those with a higher ECOG PS score and adrenal metastasis may benefit more from radiotherapy or supportive care.
本研究的目的是检测非小细胞肺癌(NSCLC)诊断时发生骨相关事件(SREs)和骨转移患者的预后因素。共回顾性纳入85例NSCLC患者,其中47例(55.2%)在NSCLC诊断时出现SREs。多因素逻辑回归分析确定鳞状细胞癌是SRE的危险因素。Kaplan-Meier分析表明,SRE组和无SRE组的总生存期无差异。Cox风险模型显示,较高的东部肿瘤协作组(ECOG)体能状态(PS)评分是预后不良的危险因素,而骨转移手术和分子靶向治疗是NSCLC诊断时SREs患者预后较好的因素。多因素分析显示,较高的ECOG PS评分和肾上腺转移是预后不良的危险因素,而骨转移手术和分子靶向治疗是预后较好的因素。因此,虽然手术治疗和分子靶向治疗似乎可改善NSCLC诊断时骨转移患者的预后,但ECOG PS评分较高和肾上腺转移患者可能从放疗或支持治疗中获益更多。