Abstract
BackgroundThis study aimed to describe the incidence, clinical characteristics, and prognosis of lung cancer patients with synchronous bone metastasis (SBM) and to analyze the prognostic factors of the lung cancer patients with SBM.MethodsA total of 15,716 lung cancer patients who were diagnosed between 2009 to 2018 in the Tianjin Medical University Cancer Institute and Hospital were retrospectively reviewed. Among them, patients with SBM were checked. Both the demographic and clinical characteristics were included as follows: age, gender, marital status, history of smoking, alcohol consumption, family history of tumor, Karnofsky score, lymph node metastasis, histological type. Besides, laboratory data such as alkaline phosphatase, lactate dehydrogenase, carcinoembryonic antigen, squamous cell carcinoma antigen, cytokeratin-19 fragment, and neuron specific enolase were also included. The log-rank test and multivariate Cox regression analysis were employed to reveal the potential prognostic predictors. A further analysis using the Kaplan–Meier was employed to demonstrate the difference on the prognosis of LC patients between adenocarcinoma and non-adenocarcinoma.ResultsAmong the included patients, 2738 patients (17.42%) were diagnosed with SBM. A total of 938 patients (34.3%) with SBM were successfully followed and the median survival was 11.53 months (95%CI: 10.57–12.49 months), and the 1-, 2-, and 5-year overall survival rate was 51, 17, and 8%, respectively. Multivariable Cox regression results showed history of smoking and high level of NSE were associated with the poor prognosis, while adenocarcinoma histological type was associated with better survival.ConclusionThe prevalence of SBM in lung cancer is relatively high with poor survival. The lung cancer patients with SBM showed diverse prognosis. Among all the pathological types, the division of adenocarcinoma suggested different prognosis of the lung cancer patients with SBM. The present study emphasized the importance of pathological diagnosis on prognostic determinants in lung cancer patients with SBM.
Highlights
This study aimed to describe the incidence, clinical characteristics, and prognosis of lung cancer patients with synchronous bone metastasis (SBM) and to analyze the prognostic factors of the lung cancer patients with SBM
The exclusion criteria were (1) those who were diagnosed without BM; (2) those who were diagnosed with metachronous bone metastasis (MBM) in Lung cancer (LC); (3) those who were not followed during follow-up
This study evaluated the incidence of SBM in LC, reported the clinical features and prognosis of LC patients with SBM, and identified a series of prognostic factors in LC patients with SBM
Summary
This study aimed to describe the incidence, clinical characteristics, and prognosis of lung cancer patients with synchronous bone metastasis (SBM) and to analyze the prognostic factors of the lung cancer patients with SBM. Lung cancer (LC) has become the most common cancer and the leading cause of cancer-related deaths in the world. A retrospective cohort study reported a total of 245 patients (19.1%) suffered bone metastasis (BM) among 1283 LC patients [3]. A higher incidence (28.2%) in LC was reported by Oliveira MB et al [4] and 36.9% in small cell lung cancer by Conen K [5]. A total of 62.6% of non-small cell lung cancer (NSCLC) patients showed at least one SREs and 16.8% of them showed multiple SREs [6]. The study looking into BM in LC is warrant
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