Clinicopathologic characteristics, metastasis-free survival, and skeletal-related events in 628 patients with skeletal metastases in a tertiary orthopedic and trauma center

Background Skeletal-related events (SREs) due to bone metastases (BM) significantly impact the morbidity and mortality of cancer patients. The present study sought to investigate clinicopathological characteristics, metastasis-free survival (MFS), and SREs in patients referred to a tertiary orthopedic and trauma center. Methods Data were retrieved from electronic health records (n=628). Survival curves were estimated utilizing the Kaplan-Meier method. The Cox regression model was used to determine factors influencing MFS based on estimated hazard ratios (HRs). Results Breast (55.8%) and lung (18.2%), and lung (32.9%) and prostate (16.8%) cancer were the most common cancer types in our cohort in women and men, respectively. Fifteen percent of patients presented with BM as the first manifestation of tumor disease, 23% had metastasis diagnosis on the same day of primary tumor diagnosis or within 3 months, and 62% developed BM at least 3 months after primary tumor diagnosis. Osteolytic BM were predominant (72.3%) and most commonly affecting the spine (23%). Overall median MFS was 45 months (32 (men) vs. 53 (women) months). MFS was shortest in the lung (median 15 months, 95% CI 8.05-19) and longest in breast cancer (median 82 months, 95% CI 65.29-94). Age (>= 60 vs. < 60 years) and primary cancer grading of >= 2 vs. 1 revealed prognostic relevance. Conclusion Women with breast or lung cancer, men with lung or prostate cancer, age >= 60 years, male sex, and primary cancer grading >= 2 are associated with increased risk for MBD. Intensified follow-up programs may reduce the risk of SREs and associated morbidity and mortality.

Automated summary

Skeletal-related events due to bone metastases significantly impact cancer patient morbidity and mortality. This study investigated clinicopathological characteristics, metastasis-free survival, and SREs in patients referred to a tertiary orthopedic and trauma center. Breast and lung cancer were most common in women, while lung and prostate cancer were most common in men, with age and primary cancer grading showing prognostic relevance.