Risk factors for lung metastasis at presentation with malignant primary osseous neoplasms: a population-based study

Lin Xie,Hongli Wang,Chaojun Zheng,Weibo Huang,Jianyuan Jiang

doi:10.1186/s13018-020-1571-5

Lin Xie, Hongli Wang + Show 3 more

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https://doi.org/10.1186/s13018-020-1571-5

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Abstract

BackgroundLarge population-based studies of risk factor for lung metastases at the presentation with primary osseous neoplasms are lacking and necessary. We aim to examine potential risk factors of lung metastases at presentation with primary osseous neoplasms using Surveillance, Epidemiology, and End Results (SEER) database tool.MethodsWe collected patients diagnosed with primary osseous neoplasms between 2010 and 2015 from the SEER database. Patients were divided into two groups: patients with lung metastases or patients without lung metastases. Patient characteristics such as age, sex, race, tumor size, histologic types, histologic grade, and lung metastasis were collected. Univariate and multivariate logistic regression analyses were applied to determine which characteristics were risk factors for lung metastasis at diagnosis.ResultsA total of 4459 patients were collected, and 507 patients had lung metastases at presentation. Data on age, race, gender, primary site, grade, tumor size, and histology types were enrolled into the multivariate logistic analysis. Higher grade (OR = 5.197, 95% CI 3.328 to 8.117), histology type (Ewing sarcoma: OR = 1.432, 95% CI 1.020 to 2.009; osteosarcoma: OR = 1.597, 95% CI, 1.073 to 2.377), and larger tumor size (≥ 5 cm: OR = 3.528, 95% CI 2.370 to 5.251) were associated with an increased risk of lung metastasis at presentation.ConclusionHistology types (osteosarcoma and Ewing sarcoma) were related to a higher risk of lung metastases in primary osseous neoplasms patients. Patients with osteosarcoma and lager tumors or higher tumor grade were associated with higher possibility of lung metastases. Patients with Ewing sarcoma and larger tumors have more tendency of lung metastases. These patients are supposed to receive chest CT scans at the presentation with primary osseous neoplasms.

Highlights

Primary osseous neoplasms were rare diseases with high mortality and affected patients of every age
Surgical amputation was often performed for patients with osteosarcoma before the advent of cancer chemotherapy, approximately 80% of patients still died of lung metastases [1, 2]
Based on the chi-squared test between non-metastatic and metastatic patients, an increased rate of lung metastasis was found to be associated with younger age, extremity site, higher grade, lager tumor size, osteosarcoma, and Ewing sarcoma (Table 1)

Summary

Introduction

Primary osseous neoplasms were rare diseases with high mortality and affected patients of every age. Surgical amputation was often performed for patients with osteosarcoma before the advent of cancer chemotherapy, approximately 80% of patients still died of lung metastases [1, 2]. Among these patients, most of them have no obvious symptoms over a long period of time. Large population-based studies of risk factor for lung metastases at the presentation with primary osseous neoplasms are lacking and necessary. We aim to examine potential risk factors of lung metastases at presentation with primary osseous neoplasms using Surveillance, Epidemiology, and End Results (SEER) database tool

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