Risk of cancer after lumbar fusion surgery with recombinant human bone morphogenic protein-2 (rh-BMP-2).
Risk of cancer after lumbar fusion surgery with recombinant human bone morphogenic protein-2 (rh-BMP-2).
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DOI：
10.1097/brs.0b013e3182a3d3b4
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发表时间：
2013-10-01
期刊：
影响因子：
3
通讯作者：
Kou TD
中科院分区：
文献类型：
--
作者：
Cooper GS;Kou TD
补充数字内容在文本中可用。在一组接受腰椎融合术的医疗保险受益人中，我们调查了重组人骨形态发生蛋白（rhBMP）与随后癌症风险的关系。平均随访4.7年后，rhBMP与总体癌症发病率或个体肿瘤类型的风险无关。在接受腰椎融合手术的医疗保险受益人中进行的回顾性队列研究。确定在手术中接受重组人骨形态发生蛋白（rhBMP）的患者与未接受rhBMP的患者之间后续癌症的风险。rhBMP通常用于促进脊柱手术后的骨愈合。BMP受体存在于多种癌症类型中，但接受rhBMP后患癌症的风险尚未得到充分研究。我们确定了146，278名年龄在67岁及以上的受试者，他们在2003年至2008年接受了手术，并在2010年随访了26种癌症中的1种新诊断。比例风险模型用于确定与rhBMP使用相关的癌症风险。15.1%的队列接受rhBMP给药。经过4.7年的平均随访，15.4%的rhBMP治疗患者和17.0%的未治疗患者有新的癌症诊断，最常见的类型为前列腺，乳腺，肺和结直肠。在多变量比例风险模型中，rhBMP与癌症风险无关（风险比：0.99，95%置信区间：0.95-1.02）。rhBMP与任何个体癌症类型的风险也没有关联。在使用2种偶发癌症次要定义的分析中，结果一致。在这项对医疗保险受益人的大规模人群分析中，我们没有发现腰椎融合术时给予rhBMP与癌症风险相关的证据。证据等级：4级
Supplemental Digital Content is Available in the Text. In a cohort of Medicare beneficiaries who underwent lumbar spinal fusion, we investigated the association of recombinant human bone morphogenic protein (rhBMP) and risk of subsequent cancer. After a mean follow-up of 4.7 years, rhBMP was not associated with overall cancer incidence or risk of individual tumor types. Retrospective cohort study among Medicare beneficiaries with lumbar spinal fusion surgery. To determine the risk of subsequent cancer among patients who received recombinant human bone morphogenic protein (rhBMP) at surgery compared with those who did not. rhBMP is commonly used to promote bone union after spinal surgery. BMP receptors are present on multiple cancer types, but the risk of cancer after receiving rhBMP has not been well studied. We identified 146,278 subjects aged 67 years and older who underwent surgery in 2003 to 2008 and were followed through 2010 for a new diagnosis of 1 of 26 cancers. Proportional hazards models were used to determine cancer risk associated with rhBMP use. rhBMP was administered in 15.1% of the cohort. After an overall average follow-up of 4.7 years, 15.4% of rhBMP-treated and 17.0% of untreated patients had a new cancer diagnosis, with most commonly recorded types as prostate, breast, lung, and colorectal. In a multivariate proportional hazards model, there was no association of rhBMP with cancer risk (hazard ratio: 0.99, 95% confidence interval: 0.95–1.02). There was also no association of rhBMP with the risk of any individual cancer types. The results were consistent in analyses using 2 secondary definitions of incident cancer. In this large population-based analysis of Medicare beneficiaries, we found no evidence that administration of rhBMP at the time of lumbar fusion surgery was associated with cancer risk. Level of Evidence: 4