The effect of bone metastases on survival in lung cancer

Abstract

Aim: The most common sites of distant metastasis in lung cancers are bones. In our study, we aimed to investigate the incidence of bone metastasis in lung cancers, and the effects of single and multiple bone metastases on survival. We conducted such a study to contribute to the literature due to the small number of studies on this subject. Methods: Lung cancer patients diagnosed with bone metastases in our hospital between January 2012-December 2018 were identified. A total of 103 (60.59%) patients with single bone metastasis, and 67 (39.41%) patients with multiple bone metastases were included in the study. Patients' demographic characteristics, symptoms, radiological findings, diagnostic methods, histological subtypes, survival, biochemistry values, tumor markers were analyzed retrospectively according to single and multiple bone metastases. A cohort study was conducted, and the results were presented as mean and standard deviation for continuous variables, and percentage for categorical variables. Results: Among the 170 patients included in the study, 147 (86.5%) were male, and 23 (13.5%) were female. The overall mean age of the patients was 64.32 (9.965) years. The most common symptom was dyspnea, reported by 58 (34.1%) patients. Bronchoscopic biopsy was most used for diagnosis, in 116 (68.2%) patients. Among patients with adenocarcinoma, squamous cell carcinoma, and small cell lung carcinoma, the number of those with single and multiple bone metastases were 44 (55%) and 36 (45%), 37 (75.5%) and 12 (24.5%), and 22 (53.7%) and 19 (46.3%), respectively. Vertebrae were the most common site of metastasis in single bone metastases. The mean survival times of adenocarcinoma, squamous cell carcinoma, and small cell lung carcinoma patients with single and multiple bone metastases were 14.93 (11.8) and 13.03 (9.32), 15.55 (9.41) and 9.42 (5.744), and 10.55 (8.32) and 8.79 (4.171) months, respectively. Conclusion: No significant differences were detected in terms of survival between adenocarcinoma and small cell lung cancer patients with single and multiple bone metastases. However, multiple bone metastases were observed to significantly decrease survival in squamous cell carcinoma.