Cancer Surgery
Open Access

Risk factors; Survival; Occurrence; Prognosis

Introduction

In most developed nations, lung cancer is the most common cancer in men and the leading cause of cancer-related death in women, placing a significant strain on social and family relationships. Even though lung cancer screening technology has improved over the past few years, mortality rates have not significantly decreased. Lung cancer still accounts for nearly 27% of all cancer deaths and has 5-year survival rates ranging from 4% to 17% depending on the region, despite significant declines in the number of smokers in recent years. Gender, race, sex, and histology all had a significant impact on lung cancer incidence trends across nations [1-4].

One of the most common distant metastases in lung cancer patients was bone metastasis (BM), which had a poor prognosis because it was an incurable disease. BM was found in nearly 20% of lung cancer patients under the age of 65. There was a 37.1% prevalence of BM in various metastatic patterns in non-small cell lung cancer. Despite the fact that improved medical care has increased lung cancer patients' survival rates, the risk of BM, which has a poor prognosis, has continued to rise. The lack of a standard and palliative management strategy to reduce the likelihood of BM and a prognosis assessment method was regrettable. Using the Surveillance, Epidemiology, and End Results (SEER), this study aims to estimate the prognosis for BM in lung cancer patients and examine the risk factors for BM. delver deeper into the heterogeneous and homogeneous factors. Age, race, histological type, marital status, T stage, N stage, grade classification, tumor size, brain and liver metastasis, and histological type are all factors.

Method

The National Cancer Institute's SEER program, which consisted of 18 population-based cancer registries (https://seer.cancer.gov), provided cases of lung and bronchus cancer. Nearly 28% of the population in the United States was covered by the cancer data that was collected and published in the SEER database. We accepted the administrator's agreement after sending the data agreement to the SEER administration. We were entitled to obtain patients' personal account information. Since all of the data in the SEER database were retrospective, our study did not require approval from the Institutional Review Board.

We extracted data on lung cancer patients with the presence or absence of bone metastases at the time of diagnosis from 2010 to 2015 because this database began collecting information on bone metastases at the time of diagnosis in 2010 and was updated until 2015. A flowchart was created listing the selected data. From 2010 to 2015, a total of 26,374 patients who were diagnosed with lung cancer without BM and 9212 patients who were diagnosed with lung cancer with BM were selected. After that, we got rid of patients who had incorrect information[5]. This left 8954 patients who could use the survival analysis and 25,631 patients who could use the multivariable logistic regression model.

The odds ratios (ORs) and 95 percent confidence intervals (CIs) were calculated using multivariable logistic regression, and the risk factors for developing BM at diagnosis were distinguished. The Kaplan-Meier method was used to evaluate the duration of survival; To determine the differences between the curves, the log-rank test was applied. The hazard ratios (HRs) with 95% CIs and prognostic effects of each variable on survival were analyzed using multivariable Cox proportional hazards regression was used for all statistical analyses. Significant statistically were two-sided P-values less than 0.05[6].

Result

The number of the two cohorts based on various SEER variables for the 34,585 eligible lung cancer patients who were diagnosed with BM or without BM between 2010 and 2015 is shown. We had access to all of their data, and 8954 of them, or 25.9%, had been diagnosed with BM at the time of the initial diagnosis. As a result, their demographic and clinical characteristics were included in the survival analysis, as shown in Table 2. In this cohort, the median survival time was just 2 0.12 months, while the mean survival time was just 6.61 0.26 months for patients who did not have BM, which was 4 0.16 months and 13.18 0.27 months, respectively. the possibility of bone metastasis at diagnosis was strongly correlated with male gender, younger age, adenocarcinoma, poor tumor differentiation grade, higher N stage(N3), brain and liver metastasis, respectively, while tumor size was not found to be a separate risk factor [7]. Also, there was no difference between T0 and higher T stages; however, T1 patients had a lower risk of BM.

Discussion

Vital prognostic factors selected by sex, age, race, marital status, pathologic type, and liver metastasis were portrayed graphically for BM survival and prognosis. In patients with lung cancer, the prognostic factors for BM were clearly observed. Male patients, older age, unmarried status, large cell carcinoma, squamous cell carcinoma, and liver metastasis were associated with a worse prognosis in the multivariate Cox regression model. There was no significant correlation between survival and grade, T stage, N stage, or brain metastasis. Although the size of the tumor was also a separate prognostic factor, there was no evidence that a larger tumor would result in a worse outcome. Patients with BM in Asian or Pacific Islander (PAI) patients had better outcomes, but survival was the same for all races.

Conclusion

Male gender and liver metastasis were the common risk factors for BM in lung cancer patients, according to our research. However, the development of BM was positively correlated with younger age, married status, low tumor differentiation grade, higher T stage, higher N stage, and metastasis to the brain; however, these factors were not BM prognostic factors. Patients with BM have a worse survival rate when they are older and unmarried, but neither factor influences the likelihood of BM occurring. In contrast, despite having the worst prognosis, adenocarcinoma tended to be the pathologic type with the highest risk factors for BM.

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