Park Jiwon, Kim Ji-Won, Nam Jin Hyun, Kim Youngjune, Kim Jin Won, Kang Suin, Lim Yejee, Kim Kyungim, Lee Keun-Wook
College of Pharmacy, Korea University, 2511 Sejong-Ro, Sejong, 30019, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Osteoporos Int. 2025 Jun 30. doi: 10.1007/s00198-025-07575-1.
In metastatic colorectal cancer (mCRC) patients, the incidence rate of osteoporotic fracture (OF) was comparable to that of pathologic fracture (4.5% vs 4.2% over 2 years), and even higher in those aged ≥ 70. Because age and osteoporosis are significant risk factors, assessing osteoporosis is critical to prevent OF in older mCRC patients.
Fractures in patients with metastatic colorectal cancer (mCRC) have been reported; however, most of these are pathologic fractures (PFs). This study aimed to identify the incidence rates of and risk factors for osteoporotic fracture (OF) and PF.
We retrospectively analyzed the clinical data of mCRC patients who received palliative chemotherapy.
We enrolled 622 patients (359 male) consecutively. The median patient age was 61 (range, 20-91) years. Before chemotherapy, 42 (6.8%) patients had bone metastases. During follow-up, 86 (13.8%) patients experienced 96 fracture events. The cumulative incidence rates over the 2-year period were 4.5% (95% confidence interval [CI], 2.9-6.1%) and 4.2% (95% CI, 2.6-5.8%) for OF and PF, respectively. The crude incidence rate of OF was higher than that of PF in patients aged ≥ 70 years with an incidence rate ratio of 4.65 (95% CI, 1.72-15.7). Multivariable analysis identified older age (hazard ratio [HR], 1.04 [95% CI, 1.00-1.08]; p = 0.03) and osteoporosis (HR, 4.79 [95% CI, 1.51-15.16]; p = 0.01) as significant risk factors for OF after adjustment for bone and cancer-related variables. For PF, bone metastasis was a significant risk factor (HR, 9.48 [95% CI, 4.02-22.38]; p < 0.01).
The incidence rate of OF was comparable to that of PF and even higher in mCRC patients aged ≥ 70 years. While bone metastasis was a risk factor for PF, advanced age and osteoporosis were the risk factors for OF. Therefore, osteoporosis assessment and treatment are crucial to prevent OF during chemotherapy, particularly in the elderly.
在转移性结直肠癌（mCRC）患者中，骨质疏松性骨折（OF）的发生率与病理性骨折相当（2年内分别为4.5%和4.2%），在年龄≥70岁的患者中甚至更高。由于年龄和骨质疏松是重要的风险因素，评估骨质疏松对于预防老年mCRC患者发生OF至关重要。
已有关于转移性结直肠癌（mCRC）患者骨折的报道；然而，其中大多数是病理性骨折（PFs）。本研究旨在确定骨质疏松性骨折（OF）和PF的发生率及危险因素。
我们回顾性分析了接受姑息化疗的mCRC患者的临床资料。
我们连续纳入了622例患者（359例男性）。患者的中位年龄为61岁（范围20 - 91岁）。化疗前，42例（6.8%）患者有骨转移。在随访期间，86例（13.8%）患者发生了96次骨折事件。2年期间OF和PF的累积发生率分别为4.5%（95%置信区间[CI]，2.9 - 6.1%）和4.2%（95%CI，2.6 - 5.8%）。在年龄≥70岁的患者中，OF的粗发生率高于PF，发生率比为4.65（95%CI，1.72 - 15.7）。多变量分析确定，在对骨骼和癌症相关变量进行调整后，年龄较大（风险比[HR]，1.04[95%CI，1.00 - 1.08]；p = 0.03）和骨质疏松（HR，4.79[95%CI，1.51 - 15.16]；p = 0.01）是OF的重要危险因素。对于PF，骨转移是一个重要危险因素（HR，9.48[95%CI，4.
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