A Survival Scoring System for Non-Small Cell Lung Cancer Patients with De Novo Bone Metastases

Abstract

In the pre-tyrosine kinase inhibitors (TKIs) era, non-small cell lung cancer (NSCLC) patients with de novo bone metastases had a worse prognosis than those without. However, whether epidermal growth factor receptor (EGFR)-TKIs affect the outcomes of EGFR mutant NSCLC patients with de novo bone metastases has not been well studied thus far. We retrospectively studied the effect of EGFR mutation status and first-line EGFR-TKIs on patient outcomes and created a survival scoring system for NSCLC patients with de novo bone metastases. This retrospective study evaluated 1510 NSCLC patients diagnosed between November 2010 and March 2014. Among these patients, 234 patients had de novo bone metastases. We found that 121 of these 234 patients (51.7%) had positive EGFR mutation tests, and a positive EGFR mutation test significantly affected overall survival (OS) (EGFR mutant: 15.2 months, EGFR wild type: 6.5 months; p < 0.001). Other prognostic factors significant in the multivariable analysis for NSCLC with de novo bone metastases included Eastern Cooperative Oncology Group performance status (PS) (OS; PS 0–2: 11.2 months, PS 3–4: 4.9 months; p = 0.002), presence of extraosseous metastases (OS; with extraosseous metastases: 8.8 months, without extraosseous metastases: 14.0 months; p = 0.008), blood lymphocyte-to-monocyte ratio (LMR) (OS; LMR > 3.1: 17.1months, LMR ≤ 3.1: 6.9months; p < 0.001). A positive EGFR mutation status reversed the poor outcomes of NSCLC patients with de novo bone metastases. A simple and useful survival scoring system including the above clinical parameters was thus created for NSCLC patients with de novo bone metastases.

Survival and Factors Affecting it in Lung Cancer Patients Referred to Imam Khomeini Clinic in Hamadan Province

“…Moreover, the median survival time of patients with lung cancer in the United States has also increased in recent decades, reaching from 12.4 months to 14.8 months, which can be attributed to the advances of treatment strategies such as radiotherapy and chemotherapy in this country (22,23). The mean age at diagnosis in this study was 61.84 years, which is consistent with the results of many studies in Iran and other countries (1,19,24,25). The results of the present study indicate that the presence of metastasis is an important and effective factor in the survival of patients with lung cancer, which indicates a decrease in survival rate in patients with metastasis cancer.…”

“…In this study, the results of data analysis indicated that the variables of metastasis and site of metastasis significantly affected the survival of patients. The mean and median survival rates calculated in the present study are close to those obtained in studies by Julka et al, Crvenkova, and Chen et al (16,19,20). Some iejm.hums.ac.ir http studies reported lower survival rates than those estimated in the present study; for example, the mean and median survival time in the study by Abazari et al were calculated to be 13 and 4.8 months, respectively (1).…”

Impact of Use of Gastric-Acid Suppressants and Oral Anticancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis

“…A total of 353 potentially eligible records were identified in the electronic databases. After exclusion of n=337 not pertinent papers, n=16 were selected for inclusion in quantitative analysis (n=372,418 patients included, with 12% of patients receiving concomitant GAS therapy) [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The search results and characteristics of the included studies are presented in figure 1 and tables 1-2.…”