Prognostic Factors of Bone Metastases From Colorectal Cancer in the Era of Targeted Therapy.
Journal
Diseases of the colon and rectum
ISSN: 1530-0358
Titre abrégé: Dis Colon Rectum
Pays: United States
ID NLM: 0372764
Informations de publication
Date de publication:
01 03 2023
01 03 2023
Historique:
pubmed:
4
3
2022
medline:
17
2
2023
entrez:
3
3
2022
Statut:
ppublish
Résumé
Various prognostic factors have been reported for bone metastases from different primary tumor sites. However, bone metastases from colorectal cancer are very rare, and the prognostic factors have not been investigated in detail. This study aimed to identify prognostic factors of bone metastases from colorectal cancer. This is a retrospective cohort study using data from a prospectively collected database. This study was conducted at a single tertiary care cancer center in Japan. Patients who developed bone metastases from colorectal cancer during the study period among all patients who received initial treatment for colorectal cancer at our hospital between 2005 and 2016 (n = 4538) were included. Overall survival after diagnosis of bone metastases from colorectal cancer was the main outcome measure. Ninety-four patients developed bone metastases during the study period. The 5-year overall survival rate was 11.0%. Multivariable analysis identified the following independent risk factors associated with poor prognosis: ≥70 years of age at diagnosis of bone metastases (HR, 2.48; 95% CI, 1.24-4.95; p < 0.01), curative surgery not performed as initial treatment (HR, 2.54; 95% CI, 1.24-5.19; p = 0.01), multiple bone metastases (HR, 2.44; 95% CI, 1.30-4.57; p < 0.01), albumin level <3.7 g/dL (HR, 3.80; 95% CI, 1.95-7.39; p < 0.01), CEA ≥30 ng/mL (HR, 1.94; 95% CI, 1.09-3.46; p = 0.02), and less than 3 chemotherapy options remaining at diagnosis of bone metastases (HR, 2.83; 95% CI, 1.51-5.30; p < 0.01). The median survival times for patients with 0-2, 3, and 4-6 risk factors were 25.0, 8.8, and 4.3 months, respectively. The main limitation is the single-center, retrospective design of this study. Our results may facilitate multidisciplinary decision-making in patients with bone metastases from colorectal cancer. See Video Abstract at http://links.lww.com/DCR/B930 . ANTECEDENTES:Se han reportado varios factores pronósticos para las metástasis óseas de diferentes sitios de tumores primarios. Sin embargo, las metástasis óseas del cáncer colorrectal son muy raras y los factores pronósticos no se han investigado en detalle.OBJETIVO:Identificar los factores pronósticos de las metástasis óseas del cáncer colorrectal.DISEÑO:Estudio de cohorte retrospectivo utilizando datos de una base de datos recolectada prospectivamente.ENTORNO CLINICO:Un solo centro oncológico de atención terciaria en Japón.PACIENTES:Se seleccionaron pacientes que desarrollaron metástasis óseas de cáncer colorrectal durante el período de estudio entre todos los pacientes que recibieron tratamiento inicial para el cáncer colorrectal en nuestro hospital entre 2005 y 2016 (n = 4538).MEDIDA DE RESULTADO PRINCIPAL:Supervivencia general después del diagnóstico de metástasis óseas por cáncer colorrectal.RESULTADOS:Noventa y cuatro pacientes desarrollaron metástasis óseas, lo que representa el 2,0% de todos los pacientes con cáncer colorrectal que comenzaron el tratamiento durante el período de estudio. La tasa de supervivencia global a 5 años fue del 11,0 %. El análisis multivariable identificó los siguientes factores de riesgo independientes asociados con mal pronóstico: edad ≥70 años al momento del diagnóstico de metástasis óseas (hazard ratio 2,48, CI del 95 % 1,24-4,95, p < 0,01), cirugía curativa no realizada como tratamiento inicial (hazard ratio 2,54, CI 95 % 1,24-5,19, p = 0,01), metástasis óseas múltiples (hazard ratio 2,44, CI del 95 % 1,30-4,57, p < 0,01), nivel de albúmina <3,7 g/dL (hazard ratio 3,80, CI del 95 % 1,95 -7,39, p < 0,01), antígeno carcinoembrionario ≥30 ng/mL (hazard ratio 1,94, CI del 95 % 1,09-3,46, p = 0,02) y menos de 3 opciones de quimioterapia restantes al momento del diagnóstico de metástasis óseas (hazard ratio 2,83, 95 % CI 1,51-5,30, p < 0,01). La mediana de los tiempos de supervivencia para los pacientes con 0-2, 3 y 4-6 factores de riesgo fue de 25,0, 8,8 y 4,3 meses, respectivamente.LIMITACIONES:Diseño retrospectivo de un solo centro.CONCLUSIÓN:Nuestros resultados pueden facilitar la toma de decisiones multidisciplinares en pacientes con metástasis óseas de cáncer colorrectal. Consulte Video Resumen en http://links.lww.com/DCR/B930 . (Traducción- Dr. Francisco M. Abarca-Rendon ).
Sections du résumé
BACKGROUND
Various prognostic factors have been reported for bone metastases from different primary tumor sites. However, bone metastases from colorectal cancer are very rare, and the prognostic factors have not been investigated in detail.
OBJECTIVE
This study aimed to identify prognostic factors of bone metastases from colorectal cancer.
DESIGN
This is a retrospective cohort study using data from a prospectively collected database.
SETTINGS
This study was conducted at a single tertiary care cancer center in Japan.
PATIENTS
Patients who developed bone metastases from colorectal cancer during the study period among all patients who received initial treatment for colorectal cancer at our hospital between 2005 and 2016 (n = 4538) were included.
MAIN OUTCOME MEASURES
Overall survival after diagnosis of bone metastases from colorectal cancer was the main outcome measure.
RESULTS
Ninety-four patients developed bone metastases during the study period. The 5-year overall survival rate was 11.0%. Multivariable analysis identified the following independent risk factors associated with poor prognosis: ≥70 years of age at diagnosis of bone metastases (HR, 2.48; 95% CI, 1.24-4.95; p < 0.01), curative surgery not performed as initial treatment (HR, 2.54; 95% CI, 1.24-5.19; p = 0.01), multiple bone metastases (HR, 2.44; 95% CI, 1.30-4.57; p < 0.01), albumin level <3.7 g/dL (HR, 3.80; 95% CI, 1.95-7.39; p < 0.01), CEA ≥30 ng/mL (HR, 1.94; 95% CI, 1.09-3.46; p = 0.02), and less than 3 chemotherapy options remaining at diagnosis of bone metastases (HR, 2.83; 95% CI, 1.51-5.30; p < 0.01). The median survival times for patients with 0-2, 3, and 4-6 risk factors were 25.0, 8.8, and 4.3 months, respectively.
LIMITATIONS
The main limitation is the single-center, retrospective design of this study.
CONCLUSIONS
Our results may facilitate multidisciplinary decision-making in patients with bone metastases from colorectal cancer. See Video Abstract at http://links.lww.com/DCR/B930 .
FACTORES PRONSTICOS DE LAS METSTASIS SEAS DEL CNCER COLORRECTAL EN LA ERA DE LA TERAPIA DIRIGIDA
ANTECEDENTES:Se han reportado varios factores pronósticos para las metástasis óseas de diferentes sitios de tumores primarios. Sin embargo, las metástasis óseas del cáncer colorrectal son muy raras y los factores pronósticos no se han investigado en detalle.OBJETIVO:Identificar los factores pronósticos de las metástasis óseas del cáncer colorrectal.DISEÑO:Estudio de cohorte retrospectivo utilizando datos de una base de datos recolectada prospectivamente.ENTORNO CLINICO:Un solo centro oncológico de atención terciaria en Japón.PACIENTES:Se seleccionaron pacientes que desarrollaron metástasis óseas de cáncer colorrectal durante el período de estudio entre todos los pacientes que recibieron tratamiento inicial para el cáncer colorrectal en nuestro hospital entre 2005 y 2016 (n = 4538).MEDIDA DE RESULTADO PRINCIPAL:Supervivencia general después del diagnóstico de metástasis óseas por cáncer colorrectal.RESULTADOS:Noventa y cuatro pacientes desarrollaron metástasis óseas, lo que representa el 2,0% de todos los pacientes con cáncer colorrectal que comenzaron el tratamiento durante el período de estudio. La tasa de supervivencia global a 5 años fue del 11,0 %. El análisis multivariable identificó los siguientes factores de riesgo independientes asociados con mal pronóstico: edad ≥70 años al momento del diagnóstico de metástasis óseas (hazard ratio 2,48, CI del 95 % 1,24-4,95, p < 0,01), cirugía curativa no realizada como tratamiento inicial (hazard ratio 2,54, CI 95 % 1,24-5,19, p = 0,01), metástasis óseas múltiples (hazard ratio 2,44, CI del 95 % 1,30-4,57, p < 0,01), nivel de albúmina <3,7 g/dL (hazard ratio 3,80, CI del 95 % 1,95 -7,39, p < 0,01), antígeno carcinoembrionario ≥30 ng/mL (hazard ratio 1,94, CI del 95 % 1,09-3,46, p = 0,02) y menos de 3 opciones de quimioterapia restantes al momento del diagnóstico de metástasis óseas (hazard ratio 2,83, 95 % CI 1,51-5,30, p < 0,01). La mediana de los tiempos de supervivencia para los pacientes con 0-2, 3 y 4-6 factores de riesgo fue de 25,0, 8,8 y 4,3 meses, respectivamente.LIMITACIONES:Diseño retrospectivo de un solo centro.CONCLUSIÓN:Nuestros resultados pueden facilitar la toma de decisiones multidisciplinares en pacientes con metástasis óseas de cáncer colorrectal. Consulte Video Resumen en http://links.lww.com/DCR/B930 . (Traducción- Dr. Francisco M. Abarca-Rendon ).
Identifiants
pubmed: 35239524
doi: 10.1097/DCR.0000000000002270
pii: 00003453-202303000-00012
doi:
Types de publication
Video-Audio Media
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
401-409Informations de copyright
Copyright © The ASCRS 2022.
Références
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.
Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014;383:1490–1502.
Zhenghong, Zhu Z, Guoweijian, . Retrospective study of predictors of bone metastasis in colorectal cancer patients. J Bone Oncol. 2017;9:25–28.
Roth ES, Fetzer DT, Barron BJ, Joseph UA, Gayed IW, Wan DQ. Does colon cancer ever metastasize to bone first? A temporal analysis of colorectal cancer progression. BMC Cancer. 2009;9:274.
Sun C, Deng Y, Zhou H, Hu ZQ. Risk factors for the development of metachronous bone metastasis in colorectal cancer patients after curative resection. Int J Surg. 2015;21:145–149.
Kawamura H, Yamaguchi T, Yano Y, et al. Characteristics and prognostic factors of bone metastasis in patients with colorectal cancer. Dis Colon Rectum. 2018;61:673–678.
Zhang L, Gong Z. Clinical characteristics and prognostic factors in bone metastases from lung cancer. Med Sci Monit. 2017;23:4087–4094.
Chen S, Wang L, Qian K, et al. Establishing a prediction model for prostate cancer bone metastasis. Int J Biol Sci. 2019;15:208–220.
Kanthan R, Loewy J, Kanthan SC. Skeletal metastases in colorectal carcinomas: a Saskatchewan profile. Dis Colon Rectum. 1999;42:1592–1597.
Yazdani A, Dorri S, Atashi A, Shirafkan H, Zabolinezhad H. Bone metastasis prognostic factors in breast cancer. Breast Cancer (Auckl). 2019;13:1178223419830978.
Choi SJ, Kim JH, Lee MR, Lee CH, Kuh JH, Kim JR. Long-term disease-free survival after surgical resection for multiple bone metastases from rectal cancer. World J Clin Oncol. 2011;2:326–328.
Santini D, Tampellini M, Vincenzi B, et al. Natural history of bone metastasis in colorectal cancer: final results of a large Italian bone metastases study. Ann Oncol. 2012;23:2072–2077.
Li A, Käsmann L, Rades D, Fu C. A scoring system to predict the development of bone metastasis after radical resection of colorectal cancer. Anticancer Res. 2017;37:5169–5172.
Tokuhashi Y, Uei H, Oshima M, Ajiro Y. Scoring system for prediction of metastatic spine tumor prognosis. World J Orthop. 2014;5:262–271.
Katagiri H, Okada R, Takagi T, et al. New prognostic factors and scoring system for patients with skeletal metastasis. Cancer Med. 2014;3:1359–1367.
Baek SJ, Hur H, Min BS, Baik SH, Lee KY, Kim NK. The characteristics of bone metastasis in patients with colorectal cancer: a long-term report from a single institution. World J Surg. 2016;40:982–986.
Shida D, Tanabe T, Boku N, et al. Prognostic value of primary tumor sidedness for unresectable stage IV colorectal cancer: a retrospective study. Ann Surg Oncol. 2019;26:1358–1365.
Shida D, Boku N, Tanabe T, et al. Primary tumor resection for stage IV colorectal cancer in the era of targeted chemotherapy. J Gastrointest Surg. 2019;23:2144–2150.
Paulino Pereira NR, Mclaughlin L, Janssen SJ, et al. The SORG nomogram accurately predicts 3- and 12-months survival for operable spine metastatic disease: external validation. J Surg Oncol. 2017;115:1019–1027.
Grothey A, Sargent D, Goldberg RM, Schmoll HJ. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol. 2004;22:1209–1214.
Jung M, Ahn JB, Chang JH, et al. Brain metastases from colorectal carcinoma: prognostic factors and outcome. J Neurooncol. 2011;101:49–55.
Imaizumi J, Shida D, Narita Y, et al. Prognostic factors of brain metastases from colorectal cancer. BMC Cancer. 2019;19:755.
Ghori AK, Leonard DA, Schoenfeld AJ, et al. Modeling 1-year survival after surgery on the metastatic spine. Spine J. 2015;15:2345–2350.
Ghuman S, Van Hemelrijck M, Garmo H, et al. Serum inflammatory markers and colorectal cancer risk and survival. Br J Cancer. 2017;116:1358–1365.
Wang F, Li P, Li FS. Prognostic role of C-reactive protein to albumin ratio in colorectal cancer: a meta analysis. Medicine (Baltimore). 2019;98:e16064.
Wei Y, Xu H, Dai J, et al. Prognostic significance of serum lactic acid, lactate dehydrogenase, and albumin levels in patients with metastatic colorectal cancer. Biomed Res Int. 2018;2018:1804086.
Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.
McMillan DC, Watson WS, O’Gorman P, Preston T, Scott HR, McArdle CS. Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss. Nutr Cancer. 2001;39:210–213.
Dotan E, Tew WP, Mohile SG, et al. Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors. Cancer. 2020;126:1708–1716.
Song M, Chan AT. The potential role of exercise and nutrition in harnessing the immune system to improve colorectal cancer survival. Gastroenterology. 2018;155:596–600.
Bates T. A review of local radiotherapy in the treatment of bone metastases and cord compression. Int J Radiat Oncol Biol Phys. 1992;23:217–221.
Nielsen OS, Munro AJ, Tannock IF. Bone metastases: pathophysiology and management policy. J Clin Oncol. 1991;9:509–524.