Retrospective study of predictors of bone metastasis in colorectal cancer patients

Abstract

BackgroundWe explored risk factors for bone metastasis (BMs) in colorectal cancer (CRC) to improve in early diagnosis and follow-up and to reduce bone metastasis.MethodsWith a retrospective analysis of 2066 patients with CRC treated in our institution from January 2006 to January 2015, we assessed high-risk variables associated with bone metastasis using univariate and multivariate analyses.ResultsOf those subjects studied, 102 patients developed BMs, including 62 of 1014 the rectal cancer patients and 40 of the 1052 colon cancer patients. Lung metastases were accounting for 59.8% of the BMs (χ2 = 17.7, p<0.01) and hepatic metastases were accounting for 34.3% of BMs (χ2 = 3.06,p >0.05). BMs were diagnosed more rapidly in the presence of lung metastases(6.9 months versus 11.6 months for liver metastases). Univariate analysis revealed that BMs were associated with primary tumor location (p < 0.001), lung metastases (p < 0.001), initial stage (p = 0.001), radiotherapy (p < 0.001) and serum carcinoembryonic antigen (CEA) (p=0.001). Multivariate analysis revealed that primary tumor location (rectum), lung metastases, and serum CEA (>5 μg/L) were statistically significant (p <0.05).ConclusionsBMs in rectal cancer occur more frequently than in colon cancer. Lung metastases predicted potential progression to bone in CRCs more than liver metastases. Primary rectal locations, lung metastases and serum CEA were independent risk factors for BMs in CRC. Thus, patients should receive early bones scanning when presenting with CRC.

The risk factors for bone metastases in patients with colorectal cancer

“…In previous study, Liu et al [ 21 ] revealed that a high CEA level in CRC patients with BM was prone to a poor prognosis. And Zhenghong et al [ 4 ] suggested that elevated CEA was also one of the risk factors for predicting BM in patients with CRC, which was consistent with our results. As a risk factor for diagnosing BM in CRC, the accuracy of it was good (AUC = 0.791), and the sensitivity and specificity were 81.1% and 70.6%, respectively.…”

“…In previous studies, the tumor location was detected to be an independent risk factor for predicting BM in CRC. [ 4 , 17 ] But this result was not confirmed in our study.…”

“…Colorectal cancer (CRC) is a commonly malignant tumors and is the main cause of cancer-related death in patients, [ 1 – 3 ] with approximately 1.2 million new cases occurred each year. [ 4 ] So far, surgery remained the most important option for treating CRC, but 30% of patients still developed metastases. [ 5 ] It was well know that liver and lung were the most common sites of distant metastases in CRC.…”

Colorectal Cancer and Bone Tissue: Fantastic Relations and Where to Find Them

“…In CRC, bone metastases usually develop later than those in other organs or tissue, such as liver and lung metastases, and there is a preferential link between bone and lung metastases. The prognosis is more severe in cases in which the metastasis of the tumor involves several sites simultaneously [22]. Bone metastases, perhaps more than others, are highly debilitating because of the various bone-related clinical pictures that they entail.…”

“…Studies on this topic were performed by evaluating cases of rectal or colon cancer cases individually. Recently, Zhenghong et al [22] have reported a higher percentage of bone metastases in rectal cancer patients than in CRC patients. Probably, this finding may depend on the broader vascularization in the rectum compared to the colon [23,24].…”