Bone metastasis from gastric cancer: the incidence, clinicopathological features, and influence on survival.
Bone metastasis from gastric cancer: the incidence, clinicopathological features, and influence on survival.
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DOI：
10.5230/jgc.2014.14.3.164
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发表时间：
2014-09
影响因子：
2.5
通讯作者：
Yalcin S
中科院分区：
文献类型：
--
作者：
Turkoz FP;Solak M;Kilickap S;Ulas A;Esbah O;Oksuzoglu B;Yalcin S
探讨胃癌骨转移的发生率、临床病理特征、治疗结果、预后因素和生存率。在2001年至2013年期间接受治疗的4，617例胃癌患者中，分析了176例骨转移患者。骨转移发生率为3.8%。最常见的组织病理学亚型为腺癌（79%），低分化（60.8%）。从确诊到骨转移的中位时间为11个月。骨转移后中位生存期为5.4个月。与中位生存时间延长相关的因素包括：孤立性骨转移（P=0.004）、高分化肿瘤（P=0.002）、姑息性化疗（P=0.003）、唑来膦酸治疗（P<0.001）、无吸烟史（P=0.007）和诊断时无转移性胃癌（P=0.01）。另一方面，高水平的乳酸脱氢酶（LDH）（危险比[HR]：1.86; P=0.015）、癌胚抗原（CEA）（HR：2.04; P=0.002）和碳水化合物抗原（CA）19-9（HR：2.94; P<0.001）与较短的生存时间相关。多因素分析中，唑来膦酸治疗（P<0.001）和体力状态（P=0.013）是独立的预后因素。吸烟史、体力状态差、低分化腺癌、LDH、CEA和CA 19-9水平高是不良预后因素，而接受化疗和唑来膦酸与胃癌骨转移患者的生存期延长相关。
To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases. Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed. The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors. Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.