Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;141(3):367-373.
doi: 10.1007/s00402-020-03417-3. Epub 2020 Mar 31.

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

Manaf H Younis  1   2 , Lorena Fuentes-Rivera  3 , Spencer Summers  1   2 , Juan Pretell-Mazzini  4   5
Affiliations

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

Manaf H Younis et al. Arch Orthop Trauma Surg. 2021 Mar.

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.

Keywords: Bone metastasis; Breast; Carcinoma; Lung; Pancreas; Prostate; Renal; Survival.

PubMed Disclaimer

References

    1. Nielsen OS, Munro AJ, Tannock IF (1991) Bone metastases: pathophysiology and management policy. J Clin Oncol 9(3):509–524 - DOI
    1. Coleman RE (2001) Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27:165–176 - DOI
    1. Ibrahim T, Mercatali L, Amadori D (2013) Bone and cancer: the osteoncology. Clin Cases Miner Bone Metab 10(2):121–123 - PubMed - PMC
    1. Nørgaard M, Jensen AØ, Jacobsen JB, Cetin K, Fryzek JP, Sørensen HT (2010) Skeletal related events, bone metastasis and survival of prostate cancer: a population based cohort study in Denmark (1999 to 2007). J Urol 184(1):162–167 - DOI
    1. Hoshi M, Taguchi S, Hayakawa K, Leguchi M, Nakamura H (2011) Evaluation of clinical problems associated with bone metastases from carcinoma from unknown primary sites. Arch Orthop Trauma Surg 131:59–64 - DOI

LinkOut - more resources