Yan Xia, Liu Hongyu, Bai Xueqi, Xu Jin, Lou Xiaojun, Wang Lai
Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
J Bone Oncol. 2025 Aug 18;54:100708. doi: 10.1016/j.jbo.2025.100708. eCollection 2025 Oct.
To characterize causes of death in patients with bone metastases and to support data-driven approaches to survivorship planning and clinical decision-making in this population.
Using data from the SEER registry (2010-2021), we identified 186,404 patients with newly diagnosed bone metastases. Causes of death were classified as related to the cancer-specific, non-cancer, or subsequent cancer. Standardized mortality ratios (SMRs) were calculated to assess excess non-cancer mortality relative to the general population.
During follow-up, 133,393 patients (71.5 %) died from the primary cancer, 11,062 (5.9 %) from non-cancer causes, and 929 (0.5 %) from other malignancies. Although cancer remained the predominant cause of death, non-cancer mortality increased over time (from 6.3 % in 2010 to 9.5 % in 2021). Cardiovascular disease, COPD, and cerebrovascular events were the most common non-cancer causes. The greatest excess mortality was observed for HIV-related infection conditions (SMR: 13.24), septicemia (10.60), suicide (6.68), and pneumonia/influenza (6.04).
Non-cancer mortality is an increasingly important contributor to death among patients with bone metastases, underscoring the need for targeted prevention strategies for infections, cardiovascular disease, and other avoidable causes in this vulnerable population.
明确骨转移患者的死亡原因，并支持基于数据的生存规划方法及该人群的临床决策。
利用监测、流行病学和最终结果（SEER）登记处（2010 - 2021年）的数据，我们确定了186,404例新诊断为骨转移的患者。死亡原因分为与癌症相关、非癌症或后续癌症。计算标准化死亡率（SMR）以评估相对于一般人群的非癌症超额死亡率。
在随访期间，133,393例患者（71.5%）死于原发性癌症，11,062例（5.9%）死于非癌症原因，929例（0.5%）死于其他恶性肿瘤。尽管癌症仍然是主要的死亡原因，但非癌症死亡率随时间增加（从2010年的6.3%增至2021年的9.5%）。心血管疾病、慢性阻塞性肺疾病（COPD）和脑血管事件是最常见的非癌症原因。在与HIV相关的感染情况（SMR：13.24）、败血症（10.60）、自杀（6.68）和肺炎/流感（6.04）中观察到最高的超额死亡率。
非癌症死亡率在骨转移患者的死亡中所占比例日益增加，这突出表明需要针对这一脆弱人群制定针对感染、心血管疾病和其他可避免原因的预防策略。
