Department of Medical Oncology, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, 130 Dong-An Road, Shanghai, 200032, China.
J Cancer Res Clin Oncol. 2019 Mar;145(3):737-746. doi: 10.1007/s00432-018-02826-7. Epub 2019 Jan 2.
Bone metastases (BM) is reported as the most frequent distant metastasis in non-small cell lung cancer (NSCLC), but the risk factors for the incidence and prognosis of BM patients in NSCLC have not been extensively elucidated. This study aimed to find risk factors to predict BM patients' morbidity and survival outcome in NSCLC.
63,505 patients of NSCLC in the Surveillance, Epidemiology and End Results database diagnosed from 2010 to 2015 were used to analyze risk factors for developing BM by conducting multivariable logistic regression. Of these patients, 6152 and 5664 BM patients diagnosed between 2010 and 2014 were selected to investigate predictive factors for BM overall survival (OS) and cancer-specific survival (CSS) using the multivariable Cox proportional hazards regression.
There were overall 7486 (11.79%) BM patients in NSCLC. The homogeneous risk factors for BM patients' morbidity and survival outcome included male, higher T stage, lymph node involvement, poor differentiation grade, brain metastases, and liver metastases. Married status, adenocarcinoma type and lung metastases were positively correlated with BM incidence, while older age, white race, unmarried status, and SCC and other NSCLC types could predict poor OS and CSS of BM in NSCLC.
The homogeneous and heterogeneous risk factors for morbidity and survival outcome of BM patients could help physicians in more precise and individualized screening and therapies for BM patients in NSCLC.
骨转移(BM)被报道为非小细胞肺癌(NSCLC)最常见的远处转移,但 NSCLC 中 BM 患者发病和预后的危险因素尚未得到广泛阐明。本研究旨在寻找预测 NSCLC 中 BM 患者发病和生存结局的危险因素。
利用 2010 年至 2015 年监测、流行病学和最终结果数据库中诊断的 63505 例 NSCLC 患者,通过多变量逻辑回归分析发生 BM 的危险因素。在这些患者中,选择了 2010 年至 2014 年间诊断的 6152 例和 5664 例 BM 患者,使用多变量 Cox 比例风险回归分析 BM 总生存(OS)和癌症特异性生存(CSS)的预测因素。
在 NSCLC 中,共有 7486 例(11.79%)BM 患者。BM 患者发病和生存结局的同质危险因素包括男性、较高的 T 分期、淋巴结受累、分化程度差、脑转移和肝转移。已婚状态、腺癌类型和肺转移与 BM 发生率呈正相关,而年龄较大、白种人、未婚状态以及 SCC 和其他 NSCLC 类型可预测 BM 患者 NSCLC 的 OS 和 CSS 较差。
BM 患者发病和生存结局的同质和异质危险因素有助于医生更精确和个体化地对 NSCLC 中 BM 患者进行筛查和治疗。