Prognostic factors for non-small cell lung cancer with bone metastasis at the time of diagnosis.
BACKGROUND
The skeletal system is one of the most common distant sites of metastatic non-small cell lung cancer (NSCLC) which may lead to skeletal-related event (SRE). The purpose of this study was to assess the frequency of SRE and the prognostic factors of overall survival (OS) in patients presenting bone metastasis in NSCLC.


METHODS
Two hundred and twenty NSCLC patients with skeletal metastases at the time of diagnosis between January 2000 and August 2007 were investigated retrospectively.


RESULTS
Forty-seven of 110 patients (43%) without a SRE at the time of diagnosis experienced their first SRE during the follow-up. Patients with squamous cell carcinoma had a 1.8-times higher risk of short OS [95% confidence interval (CI) 1.11-2.84, p=0.016], compared with patients with non-squamous cell carcinoma, and patients treated with EGFR TKIs achieved a 50% protective effect in OS compared with patients not treated with them (95% CI 0.32-0.80, p=0.004). Patients with ECOG performance status 0-1 and single bone metastasis had a 1.8-times (95% CI 1.13-2.60, p=0.003) and 2.4-times (95% CI 1.26-4.46, p=0.008) longer OS than patients with performance status≥2 and two or more bone metastases, respectively.


CONCLUSIONS
Our study demonstrated that the frequency of SRE was common and single bone metastasis, good performance status (ECOG 0, 1), EGFR TKI treatment had good prognosis and histology of squamous cell carcinoma had bad prognosis.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Hyun-Mi
HM
Bae
Se-Hoon
SH
Lee
Tae Min
TM
Kim
Dong-Wan
DW
Kim
Seok-Chul
SC
Yang
Hong Gyun
HG
Wu
Young Whan
YW
Kim
Dae Seog
DS
Heo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000556:secondary*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index