Abstract：
OBJECTIVE: Metastatic bone disease is estimated to develop in up to 17% of patients with melanoma, compromising skeleton integrity resulting in skeletal-related events (SREs), which impair quality of life and reduce survival. The objective of the study was to investigate (1) the proportion of melanoma patients developing SREs following diagnosis of bone metastasis and (2) the predictors for SREs in this patient cohort.
METHODS: Four hundred and eighty-one patients with bone metastatic melanoma from two tertiary centers in the United States from 2008 to 2018 were included. The primary outcome was 90-day and 1-year occurrence of a SRE, including pathological fractures of bones, cord compression, hypercalcemia, radiotherapy, and surgery. Fine-Gray regression analysis was performed for overall SREs and pathological fracture, with death as a competing risk.
RESULTS: By 1-year, 52% (258/481) of patients experienced SREs, and 28% (137/481) had a pathological fracture. At 90-day, lytic lesions, bone pain, elevated calcium and absolute lymphocyte, and decreased albumin and hemoglobin were associated with higher SRE risk. The same factors, except for decreased hemoglobin, were shown to predict development of SREs at 1-year.
CONCLUSIONS: The high incidence of SREs and pathological fractures warrants vigilance using the identified factors in this study and preventative measures during clinical oncological care.
METHODS: Four hundred and eighty-one patients with bone metastatic melanoma from two tertiary centers in the United States from 2008 to 2018 were included. The primary outcome was 90-day and 1-year occurrence of a SRE, including pathological fractures of bones, cord compression, hypercalcemia, radiotherapy, and surgery. Fine-Gray regression analysis was performed for overall SREs and pathological fracture, with death as a competing risk.
RESULTS: By 1-year, 52% (258/481) of patients experienced SREs, and 28% (137/481) had a pathological fracture. At 90-day, lytic lesions, bone pain, elevated calcium and absolute lymphocyte, and decreased albumin and hemoglobin were associated with higher SRE risk. The same factors, except for decreased hemoglobin, were shown to predict development of SREs at 1-year.
CONCLUSIONS: The high incidence of SREs and pathological fractures warrants vigilance using the identified factors in this study and preventative measures during clinical oncological care.
摘要：
目的：估计有17%的黑色素瘤患者会发生转移性骨病，损害骨骼完整性，导致骨骼相关事件（SRE），这会损害生活质量并降低生存率。该研究的目的是调查（1）诊断骨转移后发生SRE的黑色素瘤患者的比例，以及（2）该患者队列中SRE的预测因素。
方法：纳入了2008年至2018年来自美国两个三级中心的四百八十一名骨转移黑色素瘤患者。主要结果是90天和1年发生SRE，包括骨骼的病理性骨折,绳索压缩,高钙血症,放射治疗,和手术。对整体SRE和病理性骨折进行精细-灰色回归分析。死亡是一种竞争风险。
结果：到1年，52%(258/481)的患者经历了SRE，28％（137/481）有病理性骨折。90天,溶血性病变，骨痛,钙和绝对淋巴细胞升高，白蛋白和血红蛋白降低与较高的SRE风险相关。同样的因素,除了血红蛋白减少,被证明可以预测SREs在1年内的发展。
结论：SRE和病理性骨折的高发生率值得警惕，使用本研究中确定的因素和临床肿瘤护理期间的预防措施。
方法：纳入了2008年至2018年来自美国两个三级中心的四百八十一名骨转移黑色素瘤患者。主要结果是90天和1年发生SRE，包括骨骼的病理性骨折,绳索压缩,高钙血症,放射治疗,和手术。对整体SRE和病理性骨折进行精细-灰色回归分析。死亡是一种竞争风险。
结果：到1年，52%(258/481)的患者经历了SRE，28％（137/481）有病理性骨折。90天,溶血性病变，骨痛,钙和绝对淋巴细胞升高，白蛋白和血红蛋白降低与较高的SRE风险相关。同样的因素,除了血红蛋白减少,被证明可以预测SREs在1年内的发展。
结论：SRE和病理性骨折的高发生率值得警惕，使用本研究中确定的因素和临床肿瘤护理期间的预防措施。
