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胃癌骨转移患者的预后因素及骨相关事件

Prognostic factors and skeletal-related events in patients with bone metastasis from gastric cancer.

作者信息

Imura Yoshinori, Tateiwa Daisuke, Sugimoto Naotoshi, Inoue Akitomo, Wakamatsu Toru, Outani Hidetatsu, Tanaka Takaaki, Tamiya Hironari, Yagi Toshinari, Naka Norifumi, Okawa Sumiyo, Tabuchi Takahiro, Takenaka Satoshi

机构信息

Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka 541-8567, Japan.

Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.

出版信息

Mol Clin Oncol. 2020 Oct;13(4):31. doi: 10.3892/mco.2020.2101. Epub 2020 Jul 22.

Abstract

The number of studies on bone metastasis (BM) from gastric cancer (GC) is currently limited. Therefore, the aim of the present study was to investigate the characteristics, skeletal-related events (SREs) and prognosis of GC in patients with BMs. Data from 60 patients with BMs from GC were retrospectively retrieved and patient-, tumor- and BM-related characteristics were analyzed. Kaplan-Meier survival curves were analyzed using the univariate log-rank test. Multivariate analyses were conducted using the Cox proportional hazards model. The median patient age was 63.5 years (range, 26-83 years). Visceral or brain metastases were observed at BM diagnosis in 61.7% of the patients. Multiple BMs were detected in 83.3% and SREs occurred in 76.7% of the patients. The median overall survival (OS) after BM diagnosis and SRE occurrence was 9 months (range, 0-43 months) and 5 months (range, 0-36 months), respectively. On multivariate analysis, poor Eastern Cooperative Oncology Group performance status (P=0.030), the administration of chemotherapy prior to BM diagnosis (P<0.001) and no chemotherapy after BM diagnosis (P=0.002) were significant prognostic factors for unfavorable OS, whereas the non-use of bone-modifying agents (BMAs) was the only independent prognostic factor for poor SRE-free survival (SRS; P=0.022). Among patients without SREs at BM diagnosis, the median SRS duration was 7 months (range, 0-43 months). In conclusion, chemotherapy may confer a survival benefit in GC patients with BMs. In addition, the prognosis for GC patients with BMs presenting with SREs is poor, but treatment with BMAs may prevent or delay the development of SREs.

摘要

目前,关于胃癌(GC)骨转移(BM)的研究数量有限。因此,本研究的目的是调查发生骨转移的GC患者的特征、骨相关事件(SREs)及预后情况。我们回顾性收集了60例发生GC骨转移患者的数据,并分析了患者、肿瘤及骨转移相关特征。采用单因素对数秩检验分析Kaplan-Meier生存曲线。使用Cox比例风险模型进行多因素分析。患者的中位年龄为63.5岁(范围26 - 83岁)。在骨转移诊断时,61.7%的患者存在内脏或脑转移。83.3%的患者检测到多发骨转移,76.7%的患者发生了骨相关事件。骨转移诊断后及骨相关事件发生后的中位总生存期(OS)分别为9个月(范围0 - 43个月)和5个月(范围0 - 36个月)。多因素分析显示,东部肿瘤协作组(ECOG)体能状态差(P = 0.030)、骨转移诊断前接受化疗(P < 0.001)以及骨转移诊断后未接受化疗(P = 0.002)是总生存期不良的显著预后因素,而未使用骨改良药物(BMAs)是无骨相关事件生存期(SRS)不良的唯一独立预后因素(P = 0.022)。在骨转移诊断时无骨相关事件的患者中,无骨相关事件生存期的中位持续时间为7个月(范围0 - 43个月)。总之,化疗可能使发生骨转移的GC患者获得生存益处。此外,发生骨相关事件的GC骨转移患者预后较差,但使用骨改良药物治疗可能预防或延迟骨相关事件的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63eb/7403842/ac74435abe01/mco-13-04-02101-g00.jpg

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