Wang Rong-Chun, Liu Xiao-Long, Qi Chen, Chen Hao, Liu Yi-Yang, Li De-Min, Song Hai-Zhu, Yi Jun
Department of Cardiothoracic Surgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Cardiothoracic Surgery, Jingling Hospital, Jingling School of Clinical Medicine, Nanjing Medical University, Nanjing, China.
Transl Cancer Res. 2022 Jan;11(1):113-123. doi: 10.21037/tcr-21-2104.
This study aimed to explore predictors of bone metastasis (BM) of esophageal carcinoma (EC) and factors affecting the prognosis of EC with BM (ECBM).
We retrospectively studied the data of EC patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016. Logistic regression analysis was used to analyze the risk factors of BM. Cox regression and Fine and Gray's competing risk regression were performed to identify prognostic factors associated with all-cause and cancer-specific death, respectively. The Kaplan-Meier method was used to assess survival.
After exclusion, 8,916 patients were eligible, of whom 462 (5.2%) had ECBM. Independent risk factors of BM were age <65 years, male sex, stage T1, advanced N stage, and non-bone organ metastases. For EC, the median survival time (MST) was 17 months, and the 3- and 5-year survival rates were 31.6% and 23.3%, respectively; meanwhile, for BM, the MST was 5 months, and the 3- and 5-year survival rates were 2% and 1%, respectively. Adenocarcinoma, stage T2, the absence of non-bone organ metastases, and combined radiotherapy and chemotherapy were associated with a reduced risk of all-cause death in ECBM patients. Stage T2, the absence of non-bone organ metastases, and combined radiotherapy and chemotherapy were associated with a decreased risk of cancer-specific death in ECBM patients.
Although rare, BM severely impairs the prognosis of EC. BM predictors and factors influencing the prognosis of ECBM may help distinguish high-risk patients with BM and assess survival in ECBM patients.
本研究旨在探讨食管癌（EC）骨转移（BM）的预测因素以及影响EC伴BM（ECBM）患者预后的因素。
我们回顾性研究了2010年至2016年监测、流行病学和最终结果（SEER）数据库中EC患者的数据。采用逻辑回归分析来分析BM的危险因素。分别进行Cox回归和Fine和Gray竞争风险回归，以确定与全因死亡和癌症特异性死亡相关的预后因素。采用Kaplan-Meier法评估生存率。
排除后，8916例患者符合条件，其中462例（5.2%）有ECBM。BM的独立危险因素为年龄<65岁、男性、T1期、N分期晚期和非骨器官转移。对于EC，中位生存时间（MST）为17个月，3年和5年生存率分别为31.6%和23.3%；同时，对于BM，MST为5个月，3年和5年生存率分别为2%和1%。腺癌、T2期、无非骨器官转移以及放化疗联合应用与ECBM患者全因死亡风险降低相关。T2期、无非骨器官转移以及放化疗联合应用与ECBM患者癌症特异性死亡风险降低相关。
尽管BM罕见，但严重损害EC的预后。BM的预测因素以及影响ECBM预后的因素可能有助于区分BM高危患者并评估ECBM患者的生存情况。
