Analysis Of Clinicopathological Features And Prognostic Factors Of Gastric Cancer With Bone Metastases

Purpose:To explore the clinicopathological features,survival and prognostic factors of patients with gastric cancer with bone metastases.Method:Patients with gastric cancer with bone metastases who had complete clinical pathology and follow-up data from the Department of Oncology,the First Affiliated Hospital of Nanchang University from January 1,2015 to December 31,2017 were collected.Analysis of clinical pathological features,diagnosis and treatment and survival,single factor analysis of gender,age,ECOG score,T stage,N stage,whether or not with visceral metastases,clinical stage at the time of initial diagnosis,primary site,tissue type,degree of tissue differentiation,Lauren Classification,whether to receive chemotherapy,whether the primary lesion is palliative resection,serum alkaline phosphatase(ALP) level,platelet(PLT) count,blood calcium level,CEA,CA19-9,serum lactate dehydrogenase LDH level,or Metachronic bone metastasis,number of bone metastases,radiotherapy for bone metastases,pathological fractures,use of bisphosphonates,presence of bone marrow metastasis and survival of patients,and inclusion of meaningful factors in the Cox risk regression model To obtain independent prognostic factors related to patient survival.Result:A total of 62 patients with gastric cancer with bone metastases were included,with a median age of 55 years,male: female = 1:1,25 patients(40.3%) with synchronous bone metastases,37 patients(59.7%) with metachronous bone metastases;multiple bone metastases 51 cases(82.3%),single bone metastasis 11(17.7%);Lauren type intestinal type 28 cases 45.2%,diffuse type 22 cases(35.5%).Common metastatic sites are the spine,pelvis,ribs,clavicle,and limb bones.N3 stage(9.0 months vs 27.0 months,P=0.003),visceral metastasis(7.0 months vs 27.0 months,P=0.000),TNM stage ?/?(13.0 months vs 37.0 months,P= 0.002),poor differentiation(13.0 months vs 29.0 months,P=0.032)was associated with the first bone metastasis.The median survival time of patients with bone metastases in the whole group was 5.0 months,the survival rate in June was 48.4%,and the 1-year survival rate was 14.5%.Univariate analysis showed ECOG score 3-4 points(OR=2.403,95% confidence interval 1.116-5.173),multiple bone metastases(OR=2.098,95% confidence interval 0.985-4.471),decreased PLT count(OR=3.172,95% confidence interval 0.948-10.612)and whether or not to receive chemotherapy(OR =0.412,95% confidence interval was 0.226-0.753)correlated with survival time after bone metastasis in gastric cancer.Multivariate COX regression analysis showed that ECOG score and chemotherapy was an independent prognostic factor for patients with gastric cancer with bone metastases(OR=0.446,P=0.010).Conclusion:(1)Gastric bone metastases are more common in metachronous bone metastases,multiple bone metastases,and solitary bone metastases;the most common sites are spine,pelvis,ribs,clavicle,and limb bones;N3 staging,visceral metastasis,?/ Stage ?,poorly differentiated patients are more prone to bone metastasis.(2)The median survival time of gastric cancer bone metastasis was only 5.0 months;whether chemotherapy was an independent prognostic factor for patients with gastric cancer bone metastases.