Bone Metastasis in Esophageal Adenocarcinoma and Squamous Cell Carcinoma: A SEER-Based Study

Abstract Background: Esophageal cancer (EC) is a common worldwide disease with a higher mortality rate. Studies on EC patients with bone metastasis (BM) are rare. Our study focused on the clinicopathological features of EC patients with BM using the Surveillance, Epidemiology and End Results (SEER) database to further explore the risk factors and survival for BM.Methods: According to the inclusion and exclusion criteria, EC patients with BM were extracted from the SEER database from 2010 to 2016. Univariable analysis and multivariable logistic regression were used to study the risk factors for BM. Univariable analysis and multivariable Cox regression were performed to reveal the survival and prognostic factors for BM. The competitive risk model was made to compare the association with BM among causes of death. Propensity score matching (PSM) was used to reduce the bias.Results: A total of 5314 patients were included in this study. Patients with BM had a worse prognosis before and after PSM. Male, middle esophagus, with brain metastasis, without lung metastasis, without liver metastasis were major independent risk factors of BM. Poorly differentiated and undifferentiated, with liver metastasis, with lung metastasis and without chemotherapy were major independent prognostic factors of BM.Conclusions: Compared to patients with other metastatic sites such as liver, brain and lung, patients with BM had a worse prognosis. Our findings provide recommendations about clinical guidelines including examination and treatment for EC patients with BM.

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Incidence, Survival, and Associated Factors Estimation in Osteosarcoma Patients with Lung Metastasis: A Single-center Experience of 11 Years in Tianjin, China

10.21203/rs.3.rs-1071152/v1 ◽

2021 ◽

Author(s):

Chao Zhang ◽

Haixiao Wu ◽

Guijun Xu ◽

Wenjuan Ma ◽

Lisha Qi ◽

...

Keyword(s):

Risk Factors ◽

Overall Survival ◽

Regression Analysis ◽

Prognostic Factors ◽

Lung Metastasis ◽

Associated Factors ◽

Cox Regression ◽

Cancer Center ◽

Single Center ◽

Cox Regression Analysis

Abstract Background: Osteosarcoma is the most common primary malignant bone tumor. The current study was conducted to describe the general condition of patients with primary osteosarcoma in a single cancer center in Tianjin, China and to investigate the associated factors in osteosarcoma patients with lung metastasis. Methods: From February 2009 to October 2020, patients from Tianjin Medical University Cancer Institute and Hospital, China were retrospectively analyzed. The Kaplan–Meier method was used to evaluate the overall survival of osteosarcoma patients. Prognostic factors of patients with osteosarcoma were identified by the Cox proportional hazard regression analysis. Risk factor of lung metastasis in osteosarcoma were investigated by the logistic regression model. Results: A total of 203 patients were involved and 150 patients were successfully followed up for survival status. The 5-year survival rate of osteo-sarcoma patients was 70.0%. Surgery, bone and lung metastasis were the significant prognostic factors in multivariable Cox regression analysis. Twenty-one (10.3%) patients showed lung metastasis at the diagnosis of osteosarcoma and 67 (33%) lung metastases during the later course. T3 stage (OR=11.415, 95%CI 1.362-95.677, P=0.025) and synchronous bone metastasis (OR=6.437, 95%CI 1.69-24.51, P=0.006) were risk factors of synchronous lung metastasis occurrence. Good necrosis (≥90%, OR=0.097, 95%CI 0.028-0.332, P=0.000) and elevated Ki-67 (≥50%, OR=4.529, 95%CI 1.241-16.524, P=0.022) were proved to be significantly associated with metachronous lung metastasis occurrence. Conclusion: The overall survival, prognostic factors and risk factors for lung metastasis in this single center provided insight about osteosarcoma management.

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Risk and prognostic factors of breast cancer with liver metastases

BMC Cancer ◽

10.1186/s12885-021-07968-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lei Ji ◽

Lei Cheng ◽

Xiuzhi Zhu ◽

Yu Gao ◽

Lei Fan ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Prognostic Factors ◽

Targeted Therapy ◽

Liver Metastasis ◽

Cancer Patients ◽

Triple Negative ◽

Seer Database ◽

Breast Cancer Patients ◽

Death Risk

Abstract Background Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients. Results Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0 months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR) = 2.62; 95% confidence interval (CI) = 1.88–3.66; P < 0.001) and HR−/HER2+ (HR = 3.43; 95% CI = 2.28–5.15; P < 0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR = 0.74; 95% CI = 0.58–0.95; P < 0.001). Conclusions Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.

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Prognostic Factors in Conventional Chondrosarcoma Patients: a SEER Database Analysis

10.21203/rs.3.rs-517013/v1 ◽

2021 ◽

Author(s):

Peng Fu ◽

zhenzhen Gao ◽

Ting Sun ◽

Yi Bao ◽

Gang Chen

Keyword(s):

Risk Factors ◽

Overall Survival ◽

Prognostic Factors ◽

Survival Data ◽

Risk Model ◽

Cox Regression ◽

Survival Rates ◽

Hazards Model ◽

Small Series ◽

Prognostic Risk Factors

Abstract Background: Conventional chondrosarcoma, a rare type of bone tumor, was resistant to chemotherapy and radiation therapy, so more characteristics were needed. In clinic, the use of small series and single-institution studies have limited the investigation of chondrosarcoma. The Surveillance, Epidemiologic, and End Results is the most complete and comprehensive database worldwide. Based on this database, the study aimed to collect clinicopathological features and detect the prognosis of patients with conventional chondrosarcoma. Methods: Clinicopathologic and survival data of 782 patients from 2010 to 2016 and 353 patients from 2007 to 2009 were downloaded and analyzed. Overall survival was analyzed using the Kaplan-Meier method and verified by univariable Cox regression, and independent prognostic factors were assessed using the multi-variable Cox regression hazards model. Then, nomogram was established and the one-, three-, and five-year survival rates could be calculated with the nomogram. Competitive risk models were conducted to identify prognostic risk factors related to competitive endpoint events in patients with conventional chondrosarcoma. Results: In total, 361 extremities, 360 axial bones, and 61 cranial samples were collected from the 2010 to 2016 cohort. The median survival time of patients with conventional chondrosarcoma was 35 months, and the independent prognostic factors were sex, grade, surgery, AJCC_M age, and tumor size. Thereafter, a nomogram was established based on those independent prognostic factors. The competitive risk model revealed no competitive risk for the cancer specific endpoint event. Those data from 2007 to 2009 were used to validate the results from 2010 to 2016 with general consistency. This retrospective study determined the prognostic factors in patients with conventional chondrosarcoma using the Cox regression hazards model. A nomogram was established to help oncologists assess this rare malignant tumor with low heterogeneity.Conclusions: In the study, independent prognostic risk factors for conventional chondrosarcoma were identified, and a nomogram predicting three- and five- year overall survival rates were established, which may help physicians to predict the prognosis of patients with chondrosarcoma.

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Clinical Characteristics and Survival Outcomes in Neuroblastoma With Bone Metastasis Based on SEER Database Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.677023 ◽

2021 ◽

Vol 11 ◽

Author(s):

Bin He ◽

Jianshui Mao ◽

Leyi Huang

Keyword(s):

Risk Factors ◽

Survival Analysis ◽

Bone Metastasis ◽

Clinical Features ◽

Lung Metastasis ◽

Tumor Size ◽

Treatment Modalities ◽

Seer Database ◽

Primary Tumor Site ◽

Cox Regression Analysis

PurposeClinical features and survival analysis of neuroblastoma (NB) are well explored. However, clinical research of NB patients with bone metastasis is rarely reported. Thus, the current study was performed to analyze the clinical features, survival outcome, and risk factors in those patients.Materials and MethodsWe reviewed the Surveillance, Epidemiology, and End Results (SEER) database to select cases diagnosed with NB with bone metastasis from 2010 to 2016. Overall survival (OS) and cancer-specific survival (CSS) were analyzed through univariate Cox regression analysis. Subsequently, we performed multivariate analysis to determine independent predictors of survival. The Kaplan–Meier method was applied to intuitively show differences in prognostic value between independent risk factors.ResultsWe finally identified 393 NB patients with bone metastasis who were selected for survival analysis. Nearly half of the patients (47.3%) were aged >3 years. The adrenal gland was the primary tumor site, accounting for approximately two thirds of cases (66.2%). The 5-year OS and CSS rates of all patients were 62.1% and 64.1%, respectively. The univariate analysis indicated that age, lung metastasis, and tumor size were significantly associated with OS and CSS. Based on the multivariable analysis, age at 2 and 3 years, lung metastasis, and tumor size >10 cm remained significant negative predictors of OS and CSS.ConclusionFor NB patients with bone metastasis, three independent prognostic risk factors (age, lung metastasis, and tumor size) are helpful to clinicians for predicting prognosis and guiding treatment. Reasonable treatment modalities for these patients should be further investigated to prolong survival.

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Prognostic Factors in Patients with Conventional Chondrosarcoma: A SEER Database Analysis

10.21203/rs.3.rs-542048/v1 ◽

2021 ◽

Author(s):

Peng Fu ◽

zhenzhen Gao ◽

Ting Sun ◽

Yi Bao ◽

Gang Chen

Keyword(s):

Prognostic Factors ◽

Survival Data ◽

Risk Model ◽

Cox Regression ◽

Clinical Investigation ◽

Treatment Modalities ◽

Seer Database ◽

Rare Type ◽

Hazards Model ◽

Small Series

Abstract Background: Conventional chondrosarcoma, a rare type of bone tumor, is resistant to chemotherapy and radiation therapy. Thus, additional characteristics of this disease are needed to open other treatment modalities. The clinical investigation of chondrosarcoma is limited to small-series and single-institution studies. The Surveillance, Epidemiologic, and End Results (SEER) is the most complete and comprehensive database worldwide. This SEER database study aimed to collect clinicopathological features and determine the prognosis of patients with conventional chondrosarcoma. Methods: Clinicopathologic and survival data of 782 patients from 2010 to 2016 and 353 patients from 2007 to 2009 were downloaded and analyzed. Overall survival was analyzed using the Kaplan–Meier method and verified by univariable Cox regression. Independent prognostic factors were assessed using the multi-variable Cox regression hazards model. A nomogram was established and used to calculate the one-, three-, and five-year survival rates. Competitive risk models were established to identify the prognostic risk factors related to competitive endpoint events in patients with conventional chondrosarcoma. Results: In total, 361 extremities, 360 axial bones, and 61 cranial samples were collected from the 2010–2016 cohort. The median survival time of patients with conventional chondrosarcoma was 35 months, and the independent prognostic factors were sex, grade, surgery, AJCC_M age, and tumor size. Thereafter, a nomogram was established basing from those independent prognostic factors. The competitive risk model revealed no competitive risk for the cancer-specific endpoint event. The data from 2007 to 2009 were used to validate the results from 2010 to 2016 with general consistency. Conclusion: This retrospective study determined the prognostic factors in patients with conventional chondrosarcoma by using the Cox regression hazards model. A nomogram was established to help oncologists assess this rare malignant tumor with low heterogeneity.

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Incidence, clinical risk and prognostic factors for liver metastasis in patients with cervical cancer: a population-based retrospective study

BMC Cancer ◽

10.1186/s12885-021-08127-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hang Liu ◽

Xiangsen Ye ◽

Di Li ◽

Qian Yao ◽

Yan Li

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Liver Metastasis ◽

Cancer Patients ◽

Clinical Features ◽

Lung Metastasis ◽

Hepatic Metastasis ◽

Cox Regression ◽

Clinical Risk

Abstract Background Cervical cancer is one of the most frequent malignancies in women, particularly metastasis resulting in a poor prognosis. However, the clinical characteristics of cervical cancer patients with advanced liver metastasis have not been well investigated. We aimed to evaluate the incidence, clinical risk and prognostic factors for hepatic metastasis in cervical cancer patients. Materials and methods The clinical features of patients diagnosed with cervical cancer were collected from the Surveillance, Epidemiology and End Result (SEER) public cancer database between 2010 and 2015. Multivariate logistic and Cox regression models were performed to identify potential risk and prognostic factors for liver metastasis in patients with cervical cancer. Results A total of 431 patients (2.32%) developed liver metastasis in our analysis. The following characteristics were significantly associated with the development of liver metastasis: black ethnicity, uninsured status, higher tumor stage, poorer differentiated grade, non-squamous histology, non-surgery of primary site, patients with any additional lung, bone, and brain metastasis. Multivariate Cox regression showed that patients with additional lung metastasis, without radiotherapy, and without chemotherapy were negatively correlated with overall survival. Concurrent chemotherapy and radiotherapy was a favorable prognostic factor to improve overall survival, and chemotherapy showed to increase cause-specific survival. Additional lung metastasis was an independent characteristic for both risk and prognostic factors for hepatic metastasis in patients with cervical cancer. Conclusion Our results found several potential clinical features that may be used to assess the risk and prognosis of liver metastasis in patients with cervical cancer. These associated factors may provide clinical indications for the early identification and treatment of cervical cancer patients with hepatic metastasis.

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A Prognostic Nomogram of Colon Cancer With Liver Metastasis: A Study of the US SEER Database and a Chinese Cohort

Frontiers in Oncology ◽

10.3389/fonc.2021.591009 ◽

2021 ◽

Vol 11 ◽

Author(s):

Chuan Liu ◽

Chuan Hu ◽

Jiale Huang ◽

Kanghui Xiang ◽

Zhi Li ◽

...

Keyword(s):

Colon Cancer ◽

Liver Metastasis ◽

Bone Metastasis ◽

Lung Metastasis ◽

Tumor Size ◽

External Validation ◽

Histological Type ◽

Seer Database ◽

Training Set ◽

Internal Validation

BackgroundAmong colon cancer patients, liver metastasis is a commonly deadly phenomenon, but there are few prognostic models for these patients.MethodsThe clinicopathologic data of colon cancer with liver metastasis (CCLM) patients were downloaded from the Surveillance, Epidemiology and End Results (SEER) database. All patients were randomly divided into training and internal validation sets based on the ratio of 7:3. A prognostic nomogram was established with Cox analysis in the training set, which was validated by two independent validation sets.ResultsA total of 5,700 CCLM patients were included. Age, race, tumor size, tumor site, histological type, grade, AJCC N status, carcinoembryonic antigen (CEA), lung metastasis, bone metastasis, surgery, and chemotherapy were independently associated with the overall survival (OS) of CCLM in the training set, which were used to establish a nomogram. The AUCs of 1-, 2- and 3-year were higher than or equal to 0.700 in the training, internal validation, and external validation sets, indicating the favorable effects of our nomogram. Besides, whether in overall or subgroup analysis, the risk score calculated by this nomogram can divide CCLM patients into high-, middle- and low-risk groups, which suggested that the nomogram can significantly determine patients with different prognosis and is suitable for different patients.ConclusionHigher age, the race of black, larger tumor size, higher grade, histological type of mucinous adenocarcinoma and signet ring cell carcinoma, higher N stage, RCC, lung metastasis, bone metastasis, without surgery, without chemotherapy, and elevated CEA were independently associated with poor prognosis of CCLM patients. A nomogram incorporating the above variables could accurately predict the prognosis of CCLM.

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Risk and prognostic factors of breast cancer with liver metastases

10.21203/rs.3.rs-17121/v2 ◽

2020 ◽

Author(s):

Lei ji ◽

Lei Cheng ◽

Xiuzhi Zhu ◽

Yu Gao ◽

Lei Fan ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Prognostic Factors ◽

Targeted Therapy ◽

Liver Metastasis ◽

Cancer Patients ◽

Triple Negative ◽

Seer Database ◽

Breast Cancer Patients ◽

Death Risk

Abstract Background: Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods: Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients.Results: Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR=0.74; 95% CI=0.58-0.95; P<0.001).Conclusions: Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.

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The Homogeneous and Heterogeneous Risk Factors for the Morbidity and Prognosis of Bone Metastasis in Patients With Prostate Cancer

Journal of Global Oncology ◽

10.1200/jgo.18.38300 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 51s-51s

Author(s):

Z. Chao ◽

X. Guo ◽

Y. Xu ◽

X. Han ◽

X. Wang ◽

...

Keyword(s):

Prostate Cancer ◽

Risk Factors ◽

Prognostic Factors ◽

Bone Metastasis ◽

Bone Metastases ◽

Cancer Patients ◽

Cox Regression ◽

Preventive Treatment ◽

Tumor Stage ◽

Screening Performance

Background: Globally, prostate cancer is the second most common malignancy in males and fifth leading cancer-related cause of death. To build a reliable predictive system for screening performance, the study looking into the risk factors of BM in prostate cancer patients is warranted. Aim: Using the Surveillance, Epidemiology, and End Results database (SEER) to assess the incidence, and risk factors of morbidity and prognosis for bone metastases in initial metastatic prostate cancer. Methods: A total of 249,331 prostate cancer patients who were diagnosed between 2010 and 2014 in SEER database were obtained to investigate the risk factors for developing bone metastasis, and 9925 of them who registered before 2013 were retrieved (with at least 1 year follow-up) to explore the prognostic factors for bone metastasis. Multivariate logistic and Cox regression were used to identify risk factors and prognostic factors for bone metastases, respectively. Results: Totally, 12,794 patients (5.1%) were diagnosed with bone metastases at the initial diagnosis. Older age, unmarried status, higher tumor stage, lymph node metastasis, metastases at lung brain and liver were the homogeneous risk factors for the morbidity and prognosis of bone metastasis in prostate cancer. Race and histologic differentiation grade were the heterogeneities associated factors. Black race was positively associated with bone metastasis morbidity; however, it has no significant effect on the prognosis. Poor differentiated grade may be the risk factors for developing bone metastasis; however, grade II was negatively associated with prognosis of bone metastasis. Conclusion: The survival of prostate cancer was poor with the bone metastasis approximate 5%. The prostate cancer has homogeneous and heterogeneities risk factors for incidence and prognosis of bone metastasis, which may provide potential guideline for the screening and preventive treatment of the bone metastasis of prostate cancer.

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Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

Frontiers in Oncology ◽

10.3389/fonc.2021.694718 ◽

2021 ◽

Vol 11 ◽

Author(s):

Hejia Hu ◽

Zhan Wang ◽

Miaofeng Zhang ◽

Feng Niu ◽

Qunfei Yu ◽

...

Keyword(s):

Risk Factors ◽

Endometrial Cancer ◽

Bone Metastasis ◽

Brain Metastases ◽

Systemic Chemotherapy ◽

Tumor Grade ◽

Seer Database ◽

Tumor Subtype ◽

Local Surgery ◽

Independent Risk Factors

PurposeBone metastasis from endometrial cancer (EC) is rare and poorly described. The purpose of the present study was to investigate the correlation between the clinically accessible factors and survival time among EC patients with bone metastasis.Patients and MethodsWe retrospectively identified and reviewed EC patients with bone metastasis from 2010 to 2016, based on the Surveillance, Epidemiology and End Results (SEER) database. Univariable and multivariable Cox regressions were applied to evaluate the effects of clinical variables on survival. Kaplan–Meier plots were used to visually demonstrate the correlation between independent risk factors and survival.ResultsClinical data of 584 EC patients with bone metastasis from the SEER database were analyzed. EC patients with bone metastasis experienced extremely poor survival, with 1-year overall survival (OS) and cancer-specific survival (CSS) rates 33.8 and 35.8%, respectively. Variables associated with OS and CSS in the univariable analysis included race, tumor grade, tumor subtype, tumor size, lung, liver and brain metastases, surgery, radiotherapy, and chemotherapy. In the multivariable analysis, tumor grade, tumor subtype, liver and brain metastases, local surgery, and systemic chemotherapy remained independent risk factors for OS and CSS. However, local radiotherapy was an independent predictor of OS, not CSS.ConclusionsWe identified several factors affect the survival of EC patients with bone metastasis, which is useful for clinicians to assess patients’ outcomes. Our study supports surgery and radiotherapy of primary EC, and systemic chemotherapy for prolonging survival among EC patients with bone metastasis, which lays a solid foundation for defining optimal treatment strategy in this specific cohort.

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