title: Prognostic Factors and Skeletal-Related Events in Patients with Small Cell Lung Cancer with Bone Metastases at the Time of Diagnosis.
abstract: OBJECTIVE
  The aim of this study was to evaluate the characteristics and prognostic factors of small cell lung cancer (SCLC) with bone metastases. We also investigated the characteristics and predictive factors of skeletal-related events (SREs) in these patients.
  
  
  METHODS
  Sixty-one patients who were first diagnosed with SCLC with bone metastases at our institution were included in this retrospective analysis.
  
  
  RESULTS
  The overall survival (OS) of patients with bone metastases was shorter than that of patients without bone metastases (4.13 vs. 6.17 months, p = 0.015). Poor Eastern Cooperative Oncology Group (ECOG) performance status (PS; ≥2) and higher serum alkaline phosphatase (ALP; above upper normal limit × 2) were independent poor prognostic factors (p = 0.027 for ECOG PS, p = 0.002 for ALP). More than 1 SRE occurred in 21 patients (34.4%). Cervical spine metastasis, thoracic spine metastasis, pelvic bone metastasis, more than 5 bone metastatic regions and higher serum lactate dehydrogenase were correlated with the occurrence of SREs. Thoracic spinal metastasis was a strong predictive factor for the occurrence of SREs (odds ratio = 5.475; 95% CI: 1.080-27.755).
  
  
  CONCLUSIONS
  Our study demonstrates the poor prognosis of SCLC patients with bone metastases. Physicians should treat SCLC patients with bone metastases with caution.
authors.affiliation: Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Kang
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Min
authors.forename: Gyu Young
authors.initials: GY
authors.lastname: Hur
authors.forename: Jae Jeong
authors.initials: JJ
authors.lastname: Shim
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Kang
authors.forename: Sang Cheul
authors.initials: SC
authors.lastname: Oh
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Seo
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Lee
authors.forename: Jun Suk
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D018572:Disease-Free Survival; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology* / Q000601:surgery; D006305:Health Status Indicators; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging*; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D016103:Spinal Fractures / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D015996:Survival Rate; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging*
chemical_list: D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase