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Patterns of bone metastases in newly diagnosed colorectal cancer: a real-world analysis in the SEER database

  • Xu Guo
  • Chao Zhang
  • Wenjuan Ma
  • Fei Tian
  • Guijun Xu
  • Xiuxin Han
  • Peng Sun
  • Vladimir P. Baklaushev
  • Andrey S. Bryukhovetskiy
  • Guowen Wang
  • Yulin MaEmail author
  • Xin WangEmail author
Original Article
  • 42 Downloads

Abstract

Purpose

To investigate the incidence and the associated factors for bone metastases (BM) development and prognosis in initial colorectal cancer (CRC) with a large sample using Surveillance, Epidemiology, and End Results (SEER) cohort.

Methods

Primary CRC patients, who were initially diagnosed between 2010 and 2015 in the SEER database, were included to analyze BM incidence and risk factors for BM occurrence. The patients with at least 1-year follow-up were involved to investigate the prognostic factors for BM. Multivariable logistic and proportional hazard regression models were used to investigate the risk factors for BM development and prognosis, respectively.

Results

A total of 212,787 eligible CRC patients were included and 2557 of them were diagnosed with de novo BM (1.20%). Rectal cancer presented significantly higher BM incidence than right and left colon cancer (χ2 = 107.64, P < 0.001). T1 stage, poor differentiated grade, and brain metastases were homogeneously associated factors for BM development and BM patients’ survival. Male gender, higher N stage, rectal site, elevated carcinoembryonic antigen, and lung and liver metastases were positively associated with BM occurrence. Older age, unmarried status, right colon site, and non-surgery were found to positively correlate with the death risk of CRC patients with BM.

Conclusions

BM is rare in CRC patients. Homogeneous and heterogeneous factors were found for BM development and BM patients’ survival. The risk factors and prognostic factors can be used for BM screening and patient’s prognosis estimation.

Keywords

Bone metastases Colorectal cancer Risk factor Prognosis factor SEER 

Notes

Funding

The present study was sponsored by the Natural Science Foundation of China (81702161, 81872184, 81801781, and 81602363), the grant of Russian Foundation of Basic Research (15–29-01338), Natural Science Foundation of Tianjin Science and Technology Committee China (17JCQNJC11000), Natural Science Foundation of Tianjin Medical University (2016KYZQ10), and The Doctor Start-up Grant of Tianjin Medical University Cancer Institute and Hospital [B1612, B1711].

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The present study complied with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards and the study was approved by the Research Ethics Board of the Tianjin Medical University Cancer Institute and Hospital.

Informed consent

The SEER database is an open public database, and the release of data from the SEER database does not require informed patient consent because cancer is a reportable disease in every state of the USA.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Bone and Soft Tissue Tumors, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for CancerTianjin Medical University Cancer Institute and HospitalTianjinChina
  2. 2.Department of OrthopedicsCangzhou Central HospitalCangzhouChina
  3. 3.Department of Breast Imaging, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for CancerTianjin Medical University Cancer Institute and HospitalTianjinChina
  4. 4.Department of colorectal cancer, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for CancerTianjin Medical University Cancer Institute and HospitalTianjinChina
  5. 5.Department of General SurgeryThe Second Affiliated Hospital of Harbin Medical University Harbin, ChinaHarbinChina
  6. 6.Department of Colorectal Surgery, National Cancer CenterChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
  7. 7.Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian FederationMoscowRussian Federation
  8. 8.Department of Epidemiology and Biostatistics, First Affiliated HospitalArmy Medical UniversityChongqingChina

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