Bone Metastases Pattern in Newly Diagnosed Metastatic Bladder Cancer: A Population-Based Study

Abstract

Purpose: Based on a large-population analysis, we aimed to estimate the incidence and survival of bone metastases (BM) in initial bladder cancer (BC) patients and to identify the risk and prognostic factors of BC patients with BM.Patients and methods: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, bladder cancer patients diagnosed between 2010 and 2014 were retrieved. Multivariate logistic and Cox regression analyses were employed to identify risk factors and prognostic factors for BM in BC patients. A Kaplan-Meier analysis with log-rank test was used to estimate the overall survival for BC and the difference between the survival curves.Results: A total of 1,223 (1.39%) BC patients were diagnosed with de novo BM. Variables such as age between 41 to 60 years, black race, unmarried status, higher T stage, higher N stage, poor tumour differentiation grade, lung metastases, liver metastases, and brain metastases were positively associated with BM occurrence. The median survival for BC patients with BM was dramatically decreased to 4.0 months. Factors including advanced age, absence of surgery, and presence of lung, liver, or brain metastases all predicted worse survival.Conclusion: BM can dramatically decrease the survival of bladder cancer patients. The findings of the present study can provide population-based identification of risk and prognostic factors for BC patients with BM at initial diagnosis, which can be used for BM occurrence prediction and individualized treatment plan-making.

Patterns of distant metastases in patients with clear cell renal cell carcinoma––A population‐based analysis

“…A meta‐analysis carried out by Thompson et al 28 showed that poor differentiation was a risk factor for metastasis of cutaneous squamous cell carcinoma. Zhang et al 29 discovered that higher T stage, higher N stage, and poor tumor differentiation grade were positively related to bone metastases in initial bladder cancer. Similar conclusion was drawn in the study conducted by Moon 30 .…”

Analysis of Homogeneous and Heterogeneous Factors for Bone Metastasis in Esophageal Cancer

“…Investigating the risk factors was important for identifying patients at high risk for distant metastases [13,14] Results in our study revealed that patients with age younger than 67 years, male sex, T4 stage grade III, N1–3, histological subtype of EAC or others, and metastasis to liver, lung, and brain were more likely to have BM. These revealed risk factors can guide the identification of esophageal cancer patients with high risk of developing BM.…”

“…However, solid tumors can disrupt the delicate balance of bone physiology and result in an environment that promotes metastasis [24]. Recent studies reported the diverse homogeneous and heterogeneous associated factors in cancers correlated with bone metastasis [3,4,13,14]. Few studies have assessed the correlation between bone homeostasis and esophageal cancer, and further research is needed to identify the underlying mechanism.…”

The role of surgery on the primary tumor site in bladder cancer with distant metastasis: significance of histology type and metastatic pattern

“…We used the pathological grading standard according to the SEER database and previous studies. 15,16 The data for metastasis to distant lymph nodes, liver, lung, bone, and brain were identified at the time of diagnosis. The overall survival (OS) was considered as the endpoint.…”