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Survival in patients with carcinomas presenting with bone metastasis at diagnosis: a SEER population-based cohort study.

诊断时出现骨转移的癌症患者的生存率: 一项基于 SEER 人群的队列研究。

  • 影响因子:2.21
  • DOI:10.1007/s00402-020-03417-3
  • 作者列表:"Younis MH","Fuentes-Rivera L","Summers S","Pretell-Mazzini J
  • 发表时间:2020-03-31
Abstract

INTRODUCTION:Carcinoma metastasis to bone is a common reason for consultation to orthopedic surgeons. The presence of bone metastases (BM) is usually associated with poor prognosis which is worsened in the presence of synchronous metastases. The purpose of this study was to: (1) identify the most common carcinomas presenting with BM at diagnosis, to (2) analyze their survival, and (3) compare this against the survival of patients with additional synchronous metastasis based on a large population analysis. MATERIALS AND METHODS:Patients diagnosed with carcinoma between January 2010 and December 2015 were identified from the Surveillance, Epidemiology and End Results (SEER) database. The most common carcinomas presenting with BM at diagnosis were identified. Survival based on the presence of BM and synchronous metastases (lung, brain, liver, lymph nodes) was evaluated with Kaplan-Meier analysis. Five-year survival (%) stratified by carcinoma type was calculated. Hazard ratio (HR) for mortality comparing isolated BM to other synchronous metastases was performed. RESULTS:A total of 4.85% of patients (98,606/2,035,204) with carcinoma presented with BM at diagnosis, most commonly from a lung primary. Five-year survival with isolated BM was lowest in patients with pancreatic carcinoma (5.8%, 95% CI 3.0-9.9%), and highest in patients with breast carcinoma (41.1%, 95% CI 38.6-43.5%). Synchronous metastases increased significantly the risk of mortality within the majority of carcinomas. CONCLUSION:BM at diagnosis has a poor prognosis which is worsened if synchronous metastases are present; a fact to consider when planning orthopedic interventions. LEVEL OF EVIDENCE:Level III, prognostic study.

摘要

导读: 癌转移至骨是咨询骨科医生的常见原因。骨转移 (BM) 的存在通常与不良预后相关,当存在同步转移时,预后会恶化。本研究的目的是 :( 1) 确定诊断时表现为 BM 的最常见癌症,(2) 分析其生存率,(3) 基于大型人群分析,将其与额外同步转移患者的生存期进行比较。 材料和方法: 从监测流行病学学和最终结果 (SEER) 数据库中确定 2010年1月至 2015年12月间诊断为癌症的患者。确定了诊断时表现为 BM 的最常见癌。Kaplan-Meier 分析基于 BM 和同步转移 (肺、脑、肝、淋巴结) 的存在评估生存率。计算按癌类型分层的 5 年生存率 (%)。比较孤立 BM 与其他同步转移的死亡率风险比 (HR)。 结果: 共有 4.85% (98,606/2,035,204) 的癌症患者在诊断时表现为 BM,最常见的是肺原发。胰腺癌患者孤立 BM 的五年生存率最低 (5.8%,95% CI 3.0-9.9%),乳腺癌患者最高 (41.1%, 95% CI 38.6-43.5%)。同步转移显著增加了大多数癌症的死亡风险。 结论: BM at 诊断预后不良,如果存在同步转移,预后会恶化; 在规划骨科干预措施时要考虑的事实。 证据水平: III 级,预后研究。

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