Guo Xu, Zhang Chao, Guo Qi, Xu Yao, Feng Guowei, Li Lili, Han Xiuxin, Lu Feng, Ma Yulin, Wang Xin, Wang Guowen
Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Department of Orthopedics, Cangzhou Central Hospital, Cangzhou, Hebei, China.
Cancer Manag Res. 2018 Jun 22;10:1639-1646. doi: 10.2147/CMAR.S168579. eCollection 2018.
Using the Surveillance, Epidemiology, and End Results database (SEER) to assess the incidence and risk factors of morbidity and prognosis for bone metastases in initial metastatic prostate cancer.
The records of 249,331 prostate cancer patients in the SEER database, diagnosed between 2010 and 2014, were obtained were obtained to investigate the risk factors for developing bone metastasis, and the records of 9925 of them who registered before 2013 were retrieved (with at least 1 year follow up) to explore the prognostic factors for bone metastasis. Multivariate logistic and Cox regression were used to identify risk factors and prognostic factors for bone metastases, respectively.
In total, 12,794 patients (5.1%) were diagnosed with bone metastases at the initial diagnosis. Older age, unmarried status, lymph node metastasis, poor tumor differentiation grade (Gleason grade), metastases at lung, brain, and liver were all positively associated with risk for the morbidity and prognosis of bone metastasis in prostate cancer. Black race and higher T stage were positively associated with bone metastasis development; however, they were not associated with a prognosis of bone metastasis.
The incidence of bone metastasis in prostate cancer was approximately 5% with poor survival. The prostate cancer has homogeneous and heterogeneous risk factors for incidence and prognosis of bone metastasis, which may provide potential guidelines for the screening and preventive treatment for the bone metastasis of prostate cancer.
利用监测、流行病学和最终结果数据库(SEER)评估初发转移性前列腺癌骨转移的发病率、发病风险因素及预后情况。
获取SEER数据库中2010年至2014年间诊断的249331例前列腺癌患者的记录,以调查发生骨转移的风险因素;检索其中9925例在2013年前登记(且至少随访1年)的患者记录,以探究骨转移的预后因素。分别采用多因素logistic回归和Cox回归来确定骨转移的风险因素和预后因素。
共有12794例患者(5.1%)在初诊时被诊断为骨转移。年龄较大、未婚状态、淋巴结转移、肿瘤分化程度差(Gleason分级)、肺、脑和肝转移均与前列腺癌骨转移的发病风险及预后呈正相关。黑人种族和较高的T分期与骨转移的发生呈正相关;然而,它们与骨转移的预后无关。
前列腺癌骨转移的发生率约为5%,生存率较低。前列腺癌骨转移的发生和预后存在同质和异质的风险因素,这可能为前列腺癌骨转移的筛查和预防性治疗提供潜在指导。