Zhang Chao, Liu Lele, Tao Fang, Guo Xu, Feng Guowei, Chen Feiran, Xu Yao, Li Lili, Han Xiuxin, Baklaushev Vladimir P, Bryukhovetskiy Andrey S, 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.
J Cancer. 2018 Nov 25;9(24):4706-4711. doi: 10.7150/jca.28706. eCollection 2018.
Based on a large-population analysis, we aimed to estimate the incidence and survival of bone metastases (BM) in initial bladder cancer (BC) patients and to identify the risk and prognostic factors of BC patients with BM. Using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, bladder cancer patients diagnosed between 2010 and 2014 were retrieved. Multivariate logistic and Cox regression analyses were employed to identify risk factors and prognostic factors for BM in BC patients. A Kaplan-Meier analysis with log-rank test was used to estimate the overall survival for BC and the difference between the survival curves. A total of 1,223 (1.39%) BC patients were diagnosed with de novo BM. Variables such as age between 41 to 60 years, black race, unmarried status, higher T stage, higher N stage, poor tumour differentiation grade, lung metastases, liver metastases, and brain metastases were positively associated with BM occurrence. The median survival for BC patients with BM was dramatically decreased to 4.0 months. Factors including advanced age, absence of surgery, and presence of lung, liver, or brain metastases all predicted worse survival. BM can dramatically decrease the survival of bladder cancer patients. The findings of the present study can provide population-based identification of risk and prognostic factors for BC patients with BM at initial diagnosis, which can be used for BM occurrence prediction and individualized treatment plan-making.
基于一项大样本分析,我们旨在估计初诊膀胱癌(BC)患者骨转移(BM)的发生率和生存率,并确定BC合并BM患者的风险及预后因素。利用美国国立癌症研究所的监测、流行病学和最终结果(SEER)数据库,检索出2010年至2014年间诊断的膀胱癌患者。采用多因素逻辑回归和Cox回归分析来确定BC患者发生BM的风险因素和预后因素。采用Kaplan-Meier分析和对数秩检验来估计BC患者的总生存率以及生存曲线之间的差异。共有1223例(1.39%)BC患者被诊断为新发BM。41至60岁的年龄、黑人种族、未婚状态、较高的T分期、较高的N分期、较差的肿瘤分化程度、肺转移、肝转移和脑转移等变量与BM的发生呈正相关。BC合并BM患者的中位生存期显著缩短至4.0个月。高龄、未接受手术以及存在肺、肝或脑转移等因素均提示预后较差。BM可显著降低膀胱癌患者的生存率。本研究结果可为初诊时BC合并BM患者基于人群的风险和预后因素识别提供依据,可用于BM发生预测和个体化治疗方案制定。