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. 2023 Oct 21;13(10):e069908.
doi: 10.1136/bmjopen-2022-069908.

Prevalence and prognosis of bone metastases in common solid cancers at initial diagnosis: a population-based study

Jing Zhang  1 , Dongfeng Cai  1 , Song Hong  2
Affiliations

Prevalence and prognosis of bone metastases in common solid cancers at initial diagnosis: a population-based study

Jing Zhang et al. BMJ Open. .

Abstract

Objective: Bone is one of the most common target sites for advanced tumours. The objective was to survey the prevalence and prognosis of bone metastases in 12 common solid malignant tumours.

Design: A retrospective cohort study.

Methods: A total of 1 425 332 patients with a primary cancer between 2010 and 2015 were identified using the Surveillance, Epidemiology, and End Results database. We computed the prevalence and prognosis of bone metastases in each cancer and compared their survival in different stages. The Kaplan-Meier method and Cox logistic regression were used to analyse survival and quantify the effect of bone metastases.

Results: This study included 89 782 patients with bone metastases at diagnosis. Lung cancer had the highest prevalence (18.05%), followed by liver cancer (6.63%), nasopharyngeal carcinoma (6.33%) and renal cancer (5.45%). Breast cancer (32.1%), prostate cancer (25.9%), thyroid cancer (46.9%) and nasopharyngeal carcinoma (24.8%) with only bone metastases had a 5-year survival rate of over 20%. Compared with patients at the stage previous to metastasis, bone metastases significantly increased the risk of mortality and decreased survival, especially for those with prostate cancer (adjusted HR: 18.24). Other concomitant extraosseous metastases worsened patient survival. Bone was the most common site of metastasis for prostate cancer, while for colorectal cancer, multiorgan metastases were predominant.

Conclusions: This study provides the prevalence and prognosis of bone metastases at the initial diagnosis of common solid cancers. In addition, it demonstrates the impact of bone metastases on survival. These results can be used for early screening of metastases, clinical trial design and assessment of prognosis.

Keywords: epidemiology; oncology; orthopaedic oncology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The prevalence of patients with bone metastases in common solid cancers. A, Prevalence of bone metastases among the entire cohort. B, Prevalence of bone metastases among patients with distant metastases.
Figure 2
Figure 2
Cumulative survival and median survival of three groups, stage before metastasis, bone metastases only and bone with other sites of metastases. BM: bone metastases.
See this image and copyright information in PMC

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