Bone metastases among newly diagnosed cancer patients: a population-based study.

IF 2.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL Postgraduate Medical Journal Pub Date : 2024-07-18 DOI:10.1093/postmj/qgae036

Feng Chen, Bo He, Yang Wang

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Abstract

Purpose: (i) To analyze age-adjusted incidence rates of synchronous bone metastases diagnosed alongside primary malignancy from 2010 to 2018 in the US population, (ii) determine the incidence proportions (IPs) and characteristics of synchronous bone metastases among newly diagnosed cancer patients in the USA especially pediatric cases, and (iii) assess the implications of synchronous bone metastases on cancer patient's survival, and identify the survival risk factors for these cancer patients.

Methods: Utilizing data from the Surveillance, Epidemiology, and End Results (SEER) program (2010-2018), we calculated age-adjusted IPs and annual percentage change (APC), and employed logistic regression and Cox regression models for our analysis.

Results: 3 300 736 cancer patients were identified. The age-adjusted incidence rates of synchronous bone metastases increased from 2010 (18.04/100 000) to 2018 (20.89/100 000; APC: 2.3, 95% confidence interval [CI], 1.4-3.1), but decreased in lung cancer (average APC: -1.0, 95% CI, -1.8 to -0.3). The highest IPs were observed in pediatric neuroblastoma (43.2%; 95% CI, 39.8%-46.7%) and adult small cell carcinoma (23.1%; 95% CI, 22.7%-23.4%). Multivariate logistic analyses revealed that primary tumor characteristics were correlated with higher bone metastases risk. Survival analyses also showed varied prognostic outcomes based on metastasis sites and demographics among cancer patients. Landmark analyses further indicated among long-term cancer survivors (≥3 and ≥5 years), patients with de novo bone metastases had the poorest survival rates compared with those with other synchronous metastases (P < 0.001).

Conclusion: This study provides a population-based estimation of the incidence and prognosis for synchronous bone metastases. Our findings highlight the need for early identification of high-risk groups and multidisciplinary approaches to improve prognosis of cancer patients with de novo bone metastases.

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新诊断癌症患者的骨转移：一项基于人群的研究。

目的：(i) 分析2010年至2018年美国人群中与原发恶性肿瘤同时确诊的同步骨转移经年龄调整后的发病率；(ii) 确定美国新诊断癌症患者尤其是儿科病例中同步骨转移的发病比例（IPs）和特征；(iii) 评估同步骨转移对癌症患者生存的影响，并确定这些癌症患者的生存风险因素：利用监测、流行病学和最终结果（SEER）项目（2010-2018 年）的数据，我们计算了年龄调整后的 IPs 和年度百分比变化（APC），并采用逻辑回归和 Cox 回归模型进行分析：结果：共发现 3 300 736 名癌症患者。经年龄调整的同步骨转移发病率从2010年（18.04/100 000）上升至2018年（20.89/100 000；APC：2.3，95%置信区间[CI]，1.4-3.1），但肺癌的发病率有所下降（平均APC：-1.0，95% CI，-1.8至-0.3）。IPs最高的是小儿神经母细胞瘤（43.2%；95% CI，39.8%-46.7%）和成人小细胞癌（23.1%；95% CI，22.7%-23.4%）。多变量逻辑分析显示，原发肿瘤特征与较高的骨转移风险相关。生存分析还显示，癌症患者的预后结果因转移部位和人口统计学特征而异。标志性分析进一步表明，在长期癌症幸存者（≥3 年和≥5 年）中，与其他同步转移患者相比，新发骨转移患者的生存率最差（P 结论：本研究对同步骨转移瘤的发病率和预后进行了基于人群的估计。我们的研究结果突出表明，有必要及早识别高危人群，并采用多学科方法改善新发骨转移癌症患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Postgraduate Medical Journal 医学-医学：内科

CiteScore

8.50

自引率

2.00%

发文量

131

审稿时长

2.5 months

期刊介绍： Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.