Clinicopathologic characteristics, metastasis-free survival, and skeletal-related events in 628 patients with skeletal metastases in a tertiary orthopedic and trauma center

World Journal of Surgical Oncology

Gernot Lang¹  Eugenia Schwarzkopf¹  Georg Herget¹  Norbert Südkamp¹  Mara Wigand¹  Babak Saravi¹  Hagen Schmal²  Markus Uhl³ 

[1]Department of Orthopedics and Trauma Surgery, Medical Centre–Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany

[2]Department of Orthopedics and Trauma Surgery, Medical Centre–Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany

[3]Department of Orthopaedic Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark

[4]Department of Radiology, Pediatric Radiology, and Interventional Radiology, St. Josefskrankenhaus, Sautierstraße 1, 79104, Freiburg, Germany

关键词: Cancer;    Metastases;    Metastatic bone disease;    Skeletal-related events;    SRE;    Pathological fracture;    Spine;    Complications;    Tumor board;    Follow-up;   

DOI  :  10.1186/s12957-021-02169-7

来源: Springer

【 摘 要 】

BackgroundSkeletal-related events (SREs) due to bone metastases (BM) significantly impact the morbidity and mortality of cancer patients. The present study sought to investigate clinicopathological characteristics, metastasis-free survival (MFS), and SREs in patients referred to a tertiary orthopedic and trauma center.MethodsData were retrieved from electronic health records (n=628). Survival curves were estimated utilizing the Kaplan–Meier method. The Cox regression model was used to determine factors influencing MFS based on estimated hazard ratios (HRs).ResultsBreast (55.8%) and lung (18.2%), and lung (32.9%) and prostate (16.8%) cancer were the most common cancer types in our cohort in women and men, respectively. Fifteen percent of patients presented with BM as the first manifestation of tumor disease, 23% had metastasis diagnosis on the same day of primary tumor diagnosis or within 3 months, and 62% developed BM at least 3 months after primary tumor diagnosis. Osteolytic BM were predominant (72.3%) and most commonly affecting the spine (23%). Overall median MFS was 45 months (32 (men) vs. 53 (women) months). MFS was shortest in the lung (median 15 months, 95% CI 8.05–19) and longest in breast cancer (median 82 months, 95% CI 65.29–94). Age (≥ 60 vs. < 60 years) and primary cancer grading of ≥2 vs. 1 revealed prognostic relevance.ConclusionWomen with breast or lung cancer, men with lung or prostate cancer, age ≥60 years, male sex, and primary cancer grading ≥2 are associated with increased risk for MBD. Intensified follow-up programs may reduce the risk of SREs and associated morbidity and mortality.

【 授权许可】

CC BY