Incidence and Prognosis of Bone Metastases in Common Solid Cancers at Initial Diagnosis: A Population-Based Study

Abstract

Background Bone is one of the most common sites of advanced tumors. However, there is currently a lack of population-based surveys for the incidence and prognosis of bone metastases in common solid cancers.Methods Patients with 12 types of primary cancer and bone metastases at initial diagnosis between 2010 and 2015 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan-Meier method and Cox logistic regression were conducted to analyze survival and the effect of bone metastases on different cancers.Results We included 89,782 patients with bone metastases at cancer diagnosis. Lung cancer had the highest incidence (17.61%) of bone metastases at diagnosis in any stage, followed by liver cancer (6.29%), nasopharyngeal carcinoma (6.22%) and renal cancer (5.19%). Among patients with breast and prostate cancer, only 3.4% and 4.39%, respectively, were identified as having bone metastases at diagnosis. Breast cancer (32.1%), prostate cancer (25.2%), thyroid cancer (46.8%) and nasopharyngeal carcinoma (24.8%) patients with only bone metastasis have an over 20% five-year survival rate. Compared with patients at a stage previous to metastasis, bone metastasis significantly increased the risk of mortality and reduced survival time, especially for patients with prostate cancer (HR: 19.64, 95% CI 18.36 to 21.02). Concomitant other organ metastases make patient survival worse. Regarding the metastases of prostate cancer, bone metastases are the main type, while for colorectal cancer, bone metastases and concomitant visceral metastases mainly occur.Conclusions The findings of this study provide estimates of the incidence and prognosis of patients with bone metastases during the initial diagnosis of common solid cancers. In addition, we also clarified the degree to which bone metastasis affects patient survival. Patient prognosis depends on the primary type of cancer. These results can be used as a reference for the screening of metastases, and the optimization of personalized treatment options to improve the quality of life and survival of patients.