Abstract
Purpose
Bone metastasis (BM) can obviously affect the quality of life of patients in colorectal cancer (CRC), and the whole management of patients with BM would be attractive in current clinical practice.
Methods
A total of 52,859 patients during 2010–2015 were collected from Surveillance, Epidemiology, and End Results (SEER) database. After propensity score matching (PSM), cancer-specific survival (CCS) and overall survival (OS) with BM were adopted to assess survival probability difference. Logistic regression was used to identify risk factors for BM; COX proportion hazard regression was applied to explore prognosticators for OS in patients with BM. Subsequently, nomograms were constructed and receiver operating curves (ROCs) were used to confirm the validation of nomogram.
Results
Three hundred and forty-two (0.65%) patients were diagnosed with synchronous BM. After PSM, 16 variables were balanced. Tumor site, histology, grade, T stage, N stage, CEA, radiochemotherapy, surgery, and liver/lung/brain metastases were associated with BM, and histology, grade, T stage, N stage, CEA, chemotherapy, surgery, and liver/lung metastases were prognosticators for BM survival. Nomograms were applied and the ROC curve proved the predictive effects.
Conclusion
CRC patients with BM have worse real-world survival. Nomogram can predict incidence of BM in CRC patients and survival among patients with BM.
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Availability of data and material
Publicly available datasets were analyzed in this study. This data can be found here: https://seer.cancer.gov/.
Code availability
All statistical analyses were performed with R software, version 3.5.3 (F Foundation for Statistical Computing, Vienna, Austria) using rms, survival, tableone, Matchlt, and Hmisc packages.
Funding
This study was supported by the Grant of Science and Technology Commission of Shanghai Municipality (No. 16401970502, No.17411951100, and No. 19140902100) and the Grant of National Natural Science Foundation of China (No. 81572351 and No. 81871958).
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Conception/design: Lingyu Han, Weixing Dai, Shaobo Mo, Guoxiang Cai, Renjie Wang, and Ye Xu.
Collection and/or assembly of data: Lingyu Han, Shaobo Mo, Qingguo Li, and Wenqiang Xiang.
Data analysis and interpretation: Lingyu Han, Weixing Dai, Wenqiang Xiang, Guoxiang Cai, Qingguo Li, and Ye Xu.
Manuscript writing: Lingyu Han, Weixing Dai, Renjie Wang.
Final approval of manuscript: All listed authors.
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Han, L., Dai, W., Mo, S. et al. Nomogram to predict the risk and survival of synchronous bone metastasis in colorectal cancer: a population-based real-world analysis. Int J Colorectal Dis 35, 1575–1585 (2020). https://doi.org/10.1007/s00384-020-03612-z
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DOI: https://doi.org/10.1007/s00384-020-03612-z