Abstract
Purpose
Bone metastases (BM) is reported as the most frequent distant metastasis in non-small cell lung cancer (NSCLC), but the risk factors for the incidence and prognosis of BM patients in NSCLC have not been extensively elucidated. This study aimed to find risk factors to predict BM patients’ morbidity and survival outcome in NSCLC.
Methods
63,505 patients of NSCLC in the Surveillance, Epidemiology and End Results database diagnosed from 2010 to 2015 were used to analyze risk factors for developing BM by conducting multivariable logistic regression. Of these patients, 6152 and 5664 BM patients diagnosed between 2010 and 2014 were selected to investigate predictive factors for BM overall survival (OS) and cancer-specific survival (CSS) using the multivariable Cox proportional hazards regression.
Results
There were overall 7486 (11.79%) BM patients in NSCLC. The homogeneous risk factors for BM patients’ morbidity and survival outcome included male, higher T stage, lymph node involvement, poor differentiation grade, brain metastases, and liver metastases. Married status, adenocarcinoma type and lung metastases were positively correlated with BM incidence, while older age, white race, unmarried status, and SCC and other NSCLC types could predict poor OS and CSS of BM in NSCLC.
Conclusions
The homogeneous and heterogeneous risk factors for morbidity and survival outcome of BM patients could help physicians in more precise and individualized screening and therapies for BM patients in NSCLC.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- BM:
-
Bone metastases
- NSCLC:
-
Non-small cell lung cancer
- US:
-
The United States
- SEER:
-
Surveillance, epidemiology and end results
- OS:
-
Overall survival
- CSS:
-
Cancer-specific survival
- SREs:
-
Skeletal-related events
- NCCN:
-
National comprehensive cancer network
- K-M:
-
Kaplan–Meier
- OR:
-
Odds ratio
- CI:
-
Confidence interval
- MST:
-
Median survival time
References
Aizer AA et al (2013) Marital status and survival in patients with cancer. J Clin Oncol 31:3869
Costa L, Badia X, Chow E, Lipton A, Wardley A (2008) Impact of skeletal complications on patients’ quality of life, mobility, and functional independence supportive care. in cancer Off J Multinatl Assoc Support Care Cancer 16:879–889. https://doi.org/10.1007/s00520-008-0418-0
Erturan S, Yaman M, Aydin G, Uzel I, Musellim B, Kaynak K (2005) The role of whole-body bone scanning and clinical factors in detecting bone metastases in patients with non-small cell. Lung Cancer Chest 127:449–454. https://doi.org/10.1378/chest.127.2.449
Gomez SL et al (2016) Effects of marital status and economic resources on survival after cancer: a population-based. Study Cancer 122:1618–1625
Hirsch FR, Scagliotti GV, Mulshine JL, Kwon R, Curran WJ Jr, Wu YL, Paz-Ares L (2017) Lung cancer: current therapies and new targeted treatments Lancet (Lond Engl) 389:299–311. https://doi.org/10.1016/s0140-6736(16)30958-8
Kuchuk M, Addison CL, Clemons M, Kuchuk I, Wheatley-Price P (2013) Incidence and consequences of bone metastases in lung cancer patients. J Bone Oncol 2:22–29. https://doi.org/10.1016/j.jbo.2012.12.004
LeVasseur N, Clemons M, Hutton B, Shorr R, Jacobs C (2016) Bone-targeted therapy use in patients with bone metastases from lung cancer: a systematic review of randomized controlled trials. Cancer Treat Rev 50:183–193. https://doi.org/10.1016/j.ctrv.2016.09.013
Morgensztern D, Waqar S, Subramanian J, Gao F, Trinkaus K, Govindan R (2012) Prognostic significance of tumor size in patients with stage III non-small-cell lung cancer: a surveillance, epidemiology, and end results (SEER) survey from 1998 to 2003 J Thorac Oncol 7:1479–1484. https://doi.org/10.1097/JTO.0b013e318267d032
Quint LE et al (1996) Distribution of distant metastases from newly diagnosed non-small cell lung cancer Ann Thorac Surg 62:246–250
Riihimaki M, Hemminki A, Fallah M, Thomsen H, Sundquist K, Sundquist J, Hemminki K (2014) Metastatic sites and survival in lung cancer Lung Cancer (Amst Neth) 86:78–84. https://doi.org/10.1016/j.lungcan.2014.07.020
Siegel RL, Miller KD, PhD AJD (2018) Cancer statistics, 2018 CA: Cancer J Clin 68:11
Tanvetyanon T, Hines E Jr (2005) Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with nonsmall cell lung carcinoma and other. Solid Tumors Cancer 103:1756–1757. https://doi.org/10.1002/cncr.20996 (author reply 1757–1758)
Torok JA, Gu L, Tandberg DJ, Wang X, Harpole DH Jr, Kelsey CR, Salama JK (2017) Patterns of distant metastases after surgical management of non-small-cell lung cancer Clin Lung Cancer 18:e57-e70 https://doi.org/10.1016/j.cllc.2016.06.011
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012 CA: Cancer J Clin 65:87–108. https://doi.org/10.3322/caac.21262
Tsuya A, Kurata T, Tamura K, Fukuoka M (2007) Skeletal metastases in non-small cell lung cancer: a retrospective study Lung Cancer (Amst Neth) 57:229–232. https://doi.org/10.1016/j.lungcan.2007.03.013
Wood DE et al (2018) Lung cancer screening, version 3.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw 16:412–441. https://doi.org/10.6004/jnccn.2018.0020
Acknowledgements
This study would like to thank the author’s lover Yue Zhang for her love, support and encouragement.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests.
Rights and permissions
About this article
Cite this article
Song, Q., Shang, J., Zhang, C. et al. Impact of the homogeneous and heterogeneous risk factors on the incidence and survival outcome of bone metastasis in NSCLC patients. J Cancer Res Clin Oncol 145, 737–746 (2019). https://doi.org/10.1007/s00432-018-02826-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-018-02826-7