Clinical Characteristics And Related Prognostic Factors Of Bone Metastasis Of Colorectal Cancer

Objectives:The aims of this study were to 1)Retrospectively analyze the data of patients with colorectal metastases from Yunnan Cancer Hospital from 2001 to 2015,analyze their clinical features and related prognostic factors;2)Comprehensive evaluation of the characteristics of bone metastases and Skeleton-related events(SREs)in colorectal cancer,evaluation of the prognostic value of related hematological indicators,put forward some insights,provide a certain reference for the later clinical studies.Methods:Using the medical borrowing and retrieval system of the Third Affiliated Hospital of Kunming Medical University to collect colorectal bone metastases from January 01,2000 to December 31,2015,and collect them according to the inclusion criteria,exclusion criteria,and screening incomplete data.Including general condition data,relevant hematological parameters,and bone metastases,SREs related data,using SPSS 20.0 software for statistical analysis,explore the clinical characteristics of patients with colorectal cancer bone metastases in this study and analysis of survival and prognosis factors.Results:A total of 203 cases of colorectal cancer with bone metastases were collected,including a male to female ratio of 1.5:1 and an average age of 57.43 years.At the time of initial diagnosis,there were 150 cases(73.9%)in stage Ⅲ and Ⅳ.The most common site of rectal cancer is rectal cancer,and the main pathological type is adenocarcinoma.34(14.8%)cases of bone metastases occurred at the time of the initial diagnosis,and 21.91 months were the average time of initial bone metastases.The most common site of metastases was 145 cases(71.4%)of the spine,49 of which were single bone metastases(24.1%),and 154(75.9%)of multiple bone metastases.There were 91 cases(45.3%)with liver metastases and 98 cases(48.8%)with lung metastases.SREs occurred in 115 patients(56.65%).The average time from onset of bone metastases of colorectal cancer to SREs was 0.39 months,including bone pain,pathological fractures,and spinal cord compression that required radiation or surgery.The proportion of SREs in patients with rectal cancer at the primary site,bone metastasis at first diagnosis,bone metastasis>1,and LDH≥150 was higher,and the difference was statistically significant.When the red blood cell count of patients was higher than that of bone metastases at the time of initial diagnosis,the differences in the levels of LDH,ALP,CEA,CA-125,CA-199,and bone metastases were higher than those in the initial diagnosis.The differences were statistically significant.Patients with bone metastases who had serum albumin at the time of initial diagnosis were lower than those who did not have bone metastases at the time of initial diagnosis.Patients with poorly differentiated bone metastases at the time of initial diagnosis were more likely to have bone metastases at the time of initial diagnosis than other patients,and the results were all significant.difference.The overall survival of patients was 26.78 months.The average overall survival after bone metastases was 4.80 months.The average time for bone metastases to SREs was 0.39 months,and the average total survival time after SREs was 3.89 months.Clinical stage Ⅲ、Ⅳ,histological hypodifferentiation,newly diagnosed bone metastases,no SREs,combined hepatic metastases,CEA≥ 100,CA-724>100,AST>50,LDH<150 for their overall survival prognosis factor.Clinical staging,initial diagnosis of bone metastases,and non-occurrence of SREs are independent prognostic factors in patients with colorectal metastases.Conclusions:In this study,bone metastases were most common in primary rectal tumors,For patients with rectal cancers,bone metastases should be regularly monitored.The site of bone metastases was the most common in the spine,and multiple bone metastases were common.Patients with combined lung metastases were more common in patients with liver metastases.Hematological indicators of LDH,ALP,CEA,CA-125,CA-199 detection in bone metastasis was significantly higher than the initial diagnosis,can assist in the monitoring of disease changes.The proportion of SREs in patients with rectal cancer at the primary site,bone metastasis at first diagnosis,bone metastasis>1,and LDH≥150 was higher,which could be used as a relevant indicator for preventing and monitoring bone metastases.At the same time,patients with poor nutritional status(drop of albumin)have high rates of bone metastasis,poor prognosis,and shortened survival time.Clinical staging,initial diagnosis of bone metastasis,and non-occurrence of SREs are independent prognostic factors in patients with colorectal cancer and bone metastases,and have certain predictive value for the prognosis of colorectal bone metastases.