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影响成人骨转移后预期寿命的因素——一项5年前瞻性研究的结果

Factors Affecting Life Expectancy After Bone Metastasis in Adults - Results of a 5-year Prospective Study.

作者信息

Zacharia Balaji, Joy Jerin, Subramaniam Dhiyaneswaran, Pai Puneeth Katapadi

机构信息

Department of Orthopedics, Government Medical College, Kozhikkode, Kerala 673008 India.

出版信息

Indian J Surg Oncol. 2021 Dec;12(4):759-769. doi: 10.1007/s13193-021-01426-1. Epub 2021 Aug 30.

Abstract

There is a scarcity of literature available regarding the factors affecting life expectancy in bone metastasis (BM). Our objective is to evaluate the factors affecting life expectancy in adult patients with BM. In this prospective cohort study for over 5 years, 111 adults with BM were included in the analysis. The life expectancy was calculated from the time of diagnosis of BM to death. Statistical analysis was done using the SPSS statistical program. The Pearson chi-square test was used to analyze the significance and life expectancy was represented on the Kaplan Meier curve. The overall median survival time was 9 months. The patients with a primary malignancy detected along with BM had a median survival of 9 months. Those without a known primary at the time of diagnosis survived for a median period of 8 months and those with known primary for 14 months (-value 0.01). The median survival of patients with BM from the lung, breast, and prostate was 6, 14, and 24 months, respectively (-value 0.001). Only 22% of patients with extraskeletal metastasis in addition to BM survived more than 6 months (-value 0.013). Patients with neurological deficits had a median survival of 2 months (-value 0.0001). There was no statistically significant association between gender and the mode of treatment and survival. There was a significant association between life expectancy and mode of presentation, the primary site of origin, presence of extraskeletal secondary, BM with unknown primary, and symptoms on presentation in patients with BM.

摘要

关于影响骨转移(BM)患者预期寿命的因素,现有文献较少。我们的目的是评估影响成年BM患者预期寿命的因素。在这项为期5年多的前瞻性队列研究中,111名成年BM患者被纳入分析。预期寿命从BM诊断时间计算至死亡时间。使用SPSS统计程序进行统计分析。采用Pearson卡方检验分析显著性,并在Kaplan Meier曲线上表示预期寿命。总体中位生存时间为9个月。同时检测到原发性恶性肿瘤和BM的患者中位生存期为9个月。诊断时无已知原发性肿瘤的患者中位生存期为8个月,有已知原发性肿瘤的患者为14个月(P值0.01)。来自肺、乳腺和前列腺的BM患者中位生存期分别为6、14和24个月(P值0.001)。除BM外还伴有骨外转移的患者中,只有22%存活超过6个月(P值0.013)。有神经功能缺损的患者中位生存期为2个月(P值0.0001)。性别、治疗方式与生存之间无统计学显著关联。BM患者的预期寿命与临床表现方式、原发部位、骨外继发性肿瘤的存在、原发性不明的BM以及就诊时的症状之间存在显著关联。

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