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Prognostic risk factors in patients with bone metastasis from colorectal cancer

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Tumor Biology

Abstract

The morbidity of bone metastasis (BM) from colorectal cancer (CRC) is increasing more than ever; however, insufficient research on BM from CRC leads to reduced awareness of the issue. Therefore, the aim of this study was to evaluate the clinical features and prognostic risk factors of CRC patients with BM. Clinical data were retrospectively analyzed for a total of 242 CRC patients with BM. Of the 242 CRC patients with BM, 52 (21.5 %) had bone metastasis alone (BMA) and 190 (78.5 %) had both bone and visceral metastasis (BM&VM). The median survival time (MST) after the diagnosis of BM in all 242 patients was 15.6 months (95 % confidence interval [CI] 12.74–18.46 months). The MST of the BMA group was significantly longer than that of the BM&VM group (29.1 vs. 12.8 months, p = 0.003). Using a Cox proportional hazard model, we identified a high carcinoembryonic antigen (CEA) level and BMA as independent prognostic factors for CRC patients with BM. For the BMA group, the independent prognostic factors were elevated alkaline phosphatase (ALP) and perineural invasion of the primary cancer, which were distinct from the factors for the entire group of BM patients. Furthermore, we found that the BMA patients with multiple sites of BM had similar prognosis to the BM&VM patients. These findings together provide us with a further understanding of BM from CRC and reveal that BMA may be a distinct subset of BM from CRC that has unique independent prognostic factors and a good prognosis.

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Acknowledgments

We thank all the patients whose data were used in this study. This work was supported by the National Natural Science Foundation of China (No. 81472620).

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Authors and Affiliations

  1. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China

    Fangqi Liu, Jiang Zhao, Sanjun Cai, Hongtu Zheng & Ye Xu

  2. Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong An Road, Shanghai, 200032, China

    Fangqi Liu, Jiang Zhao, Jie Xie, Li Xie, Ji Zhu, Sanjun Cai, Hongtu Zheng & Ye Xu

  3. Department of Medical Oncology, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China

    Jie Xie

  4. Clinical Statistics Center, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China

    Li Xie & Ji Zhu

  5. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, No.270, Dong An Road, Shanghai, 200032, China

    Ji Zhu

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  1. Fangqi Liu
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  2. Jiang Zhao
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  3. Jie Xie
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  4. Li Xie
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  5. Ji Zhu
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  7. Hongtu Zheng
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  8. Ye Xu
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Correspondence to Hongtu Zheng or Ye Xu.

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Fangqi Liu, Jiang Zhao, and Jie Xie contributed equally to this work.

What does this paper add to the literature?

The prognosis and clinical features of bone metastasis (BM) from colorectal cancer (CRC) have been poorly understood because of its low incidence and the lack of sufficient research. In the present study, we describe the clinical features and prognosis of BM and identify a distinct subset with unique independent prognostic factors and a good prognosis.

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Liu, F., Zhao, J., Xie, J. et al. Prognostic risk factors in patients with bone metastasis from colorectal cancer. Tumor Biol. 37, 16127–16134 (2016). https://doi.org/10.1007/s13277-016-5465-4

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  • DOI: https://doi.org/10.1007/s13277-016-5465-4

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