Impact of the homogeneous and heterogeneous risk factors on the incidence and survival outcome of bone metastasis in NSCLC patients

  • Qian Song
  • Jun Shang
  • Chufan Zhang
  • Lanlin Zhang
  • Xianghua WuEmail author
Original Article – Clinical Oncology



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.


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.


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.


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.


Non-small cell lung cancer Bone metastasis Risk factors Morbidity Prognosis 



Bone metastases


Non-small cell lung cancer


The United States


Surveillance, epidemiology and end results


Overall survival


Cancer-specific survival


Skeletal-related events


National comprehensive cancer network




Odds ratio


Confidence interval


Median survival time



This study would like to thank the author’s lover Yue Zhang for her love, support and encouragement.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

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

Authors and Affiliations

  1. 1.Department of Medical OncologyFudan University Shanghai Cancer CenterShanghaiChina
  2. 2.Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
  3. 3.School of Life SciencesFudan UniversityShanghaiChina

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