Prognostic factors in patients with skeletal-related events at non-small-cell lung cancer diagnosis

Tominaga, Hiroyuki; Setoguchi, Takao; Shimada, Hirofumi; Nagano, Satoshi; Sasaki, Hiromi; Ishidou, Yasuhiro; Sato, Masami; Mizuno, Keiko; Inoue, Hiromasa; Komiya, Setsuro

doi:10.3892/mco.2017.1394

Cited by 7 publications

(5 citation statements)

References 31 publications

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“…The incidence of SREs in non-small-cell lung cancer ranges from 40% to 65% [28], [29], [30], and it ranges from 8.5% to 63.5% in SCLC according to reported studies [12,[30], [31], [32], [33]] (see Table 7). In a study by Katakami N et al, the incidence of SREs in SCLC was lower than that in NSCLC, and the incidence of SREs in extensive small-cell lung cancer was only 8.5% [30].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome for small cell lung cancer patients with bone metastases at the time of diagnosis

Gong

Wang

et al. 2019

Journal of Bone Oncology

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ObjectivesThe characteristics and prognostic factors of small-cell lung cancer (SCLC) patients with bone metastases at first diagnosis have scarcely been reported. This study aimed to analyze the prognostic factors of these patients and to develop a scoring system for survival to provide evidence for clinical treatment decisions.Materials and MethodsThe records of 102 SCLC patients with bone metastasis at the time of diagnosis who were seen in our hospital between May 2010 and May 2015 were retrospectively reviewed. The log-rank test and multivariate Cox regression analysis were used to evaluate potential clinical predictors of survival. A scoring system was developed based on the hazard ratios of significant independent prognostic factors.ResultThe most common site of bone metastases was the spine (64.7%), and 26 patients (25.6%) had a single bone metastasis. The median survival was 10.4 months, and the 2-year survival rate was 10.3%. Age, number of bone metastases, and occurrence of extraosseous distant metastases were significant independent prognostic factors for overall survival. Based on their scores, patients were divided into three groups. The median survival times of the three groups were 6.4 months, 8.5 months and 12.4 months, and the 2-year survival rates were 0%, 2.9%, and 19.3% (p=0.000). Twenty-six patients (25.5%) developed skeletal-related events (SREs), and the most common SREs were radiation to the bone (22.5%) and spinal cord compression (11.8%).ConclusionThis study includes preliminary clinical data of SCLC patients with bone metastases at the time of diagnosis, and more studies are needed.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome for small cell lung cancer patients with bone metastases at the time of diagnosis

Gong

Wang

et al. 2019

Journal of Bone Oncology

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“…Da Silva et al, 11 in a retrospective series of 95 patients with a median follow-up of 4.4 months, found that the overall survival time was lower in patients who experienced SREs. In contrast, Tominaga et al, 12 in a study of 85 patients, of whom 47 presented with SREs, found no statistically significant difference in overall survival between the patients who experienced SREs and those who did not. In our study, the incidence rate of mortality was higher in patients who experienced an SRE; however, the overall survival time was not significantly different between the SRE and non-SRE cohorts (p = 0.43).…”

Section: Discussionmentioning

confidence: 86%

Spine-specific skeletal related events and mortality in non–small cell lung cancer patients: a single-institution analysis

Adogwa¹,

Rubio²,

Buchowski³

et al. 2022

Journal of Neurosurgery: Spine

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OBJECTIVEThe population prevalence of non–small cell lung cancer (NSCLC) continues to increase; however, data are limited regarding the incidence rate of skeletal related events (SREs) (i.e., surgery to the spinal column, radiation to the spinal column, radiofrequency ablation, kyphoplasty/vertebroplasty, spinal cord compression, or pathological vertebral body fractures) and their impact on overall mortality. In this study, the authors sought to estimate the incidence rates of SREs in NSCLC patients and to quantify their impact on overall mortality.METHODSThis was a single-institution retrospective study of patients diagnosed with NSCLC between 2002 and 2014. The incidence rates for bone metastasis and subsequent SREs (per 1000 person-years) by time since lung cancer diagnosis were calculated and analyses were stratified separately for each histological type. Incidence rates for mortality at 1, 2, and 3 years from diagnosis stratified by the presence of SREs were also calculated. Kaplan-Meier survival curves were constructed to describe crude survival ratios in patients with spine metastasis and SREs and those with spine metastasis but without SREs. These curves were used to estimate the 1- and 2-year survival rates for each cohort.RESULTSWe identified 320 patients with incident NSCLC (median follow-up 9.5 months). The mean ± SD age was 60.65 ± 11.26 years; 94.48% of patients were smokers and 60.12% had a family history of cancer. The majority of first-time SREs were pathological vertebral body compression fractures (77.00%), followed by radiation (35%), surgery (14%), and spinal cord compression (13.04%). Mortality rates were highest in NSCLC patients with spine metastasis who had at least 1 SRE. Stratifying by histological subtype, the incidence rate of mortality in patients with SRE was highest in the large cell cohort, 7.42 per 1000 person-years (95% CI 3.09–17.84 per 1000 person-years); followed by the squamous cell cohort, 2.49 per 1000 person-years (95% CI 1.87–3.32 per 1000 person-years); and lowest in the adenocarcinoma cohort, 1.68 per 1000 person-years (95% CI 1.46–1.94 per 1000 person-years). Surgery for decompression of neural structures and stabilization of the spinal column was required in 6% of patients.CONCLUSIONSSREs in NSCLC patients with bone metastasis are associated with an increased incidence rate of mortality.

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“…Today, patients with ABC are given a larger number of choices in treatment options, including new drugs (Eribulin), endocrine treatment (Fulvestrant), molecular targeted therapies (Palbociclib, Pertuzumab) and small tyrosine-kinase inhibitors (Neratinib). As a result, the past nomogram may have underestimated the expected OS of patients treated with current chemotherapeutic and biological agents (20)(21)(22)(23). Therefore, the validations of the existing prediction models for ABC showed a modest result with poor c-statistics ranging from 0.50 to 0.63 (24).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram in survival prediction among advanced breast cancer patients

Zhao¹,

Yang²,

Pang³

et al. 2020

Ann Transl Med

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Background: The overall survival (OS) among patients with advanced breast cancer (ABC) varies greatly.Although molecular subtype is known as the most important factor in OS differentiation, significant differences in OS among patients with the same molecular subtype still occur, leading to the need for a more accurate prognostic prediction model. This study aimed to develop a prediction model (nomogram) based on current diagnosis and treatment to predict the OS of newly diagnosed ABC patients in China.Methods: From the institution's database, we collected data of 368 ABC patients from Sun Yat-sen Memorial Hospital (national hospital) as a training set to establish a nomogram with prognostic risk factors that calculated the predicted probability of survival. Nomograms were independently validated with 278 patients with ABC from two other institutions using the concordance index (C-index), calibration plots and risk group stratifications. Results:The initial primary tumor stage, molecular subtype, disease-free survival (DFS), presence of brain metastasis, and the tumor burden of metastasis disease (local recurrence, oligo-metastatic disease, or multiple-metastatic disease) were included in the prognostic nomogram. The nomogram had a C-index of 0.77 and 0.71 in the training and the validation sets, respectively. The nomogram was able to stratify patients into different risk groups, respectively (HR 6.81, 95% CI: 4.69 to 9.89, P<0.001). In the lower risk score group (risk score <11), there was no significant difference between the OS with chemotherapy and hormone therapy (HR 0.81, 95% CI: 0.44 to 1.47, P=0.48). Conclusions:We have constructed a novel prediction nomogram that can guide the physicians to select personalized treatment options. Furthermore, our study is the first to add oligo-metastatic disease and primary endocrine/trastuzumab resistance into the prognostic models.

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Prognostic factors in patients with skeletal-related events at non-small-cell lung cancer diagnosis

Cited by 7 publications

References 31 publications

Clinical outcome for small cell lung cancer patients with bone metastases at the time of diagnosis

Clinical outcome for small cell lung cancer patients with bone metastases at the time of diagnosis

Spine-specific skeletal related events and mortality in non–small cell lung cancer patients: a single-institution analysis

Development and validation of a nomogram in survival prediction among advanced breast cancer patients

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