Comprehensive analysis of cancer and non-cancer mortality in patients with bone metastases: A population-based study

IF 3.5 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2025-08-18 DOI:10.1016/j.jbo.2025.100708

Xia Yan , Hongyu Liu , Xueqi Bai , Jin Xu , Xiaojun Lou , Lai Wang

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Abstract

Purpose

To characterize causes of death in patients with bone metastases and to support data-driven approaches to survivorship planning and clinical decision-making in this population.

Methods

Using data from the SEER registry (2010–2021), we identified 186,404 patients with newly diagnosed bone metastases. Causes of death were classified as related to the cancer-specific, non-cancer, or subsequent cancer. Standardized mortality ratios (SMRs) were calculated to assess excess non-cancer mortality relative to the general population.

Results

During follow-up, 133,393 patients (71.5 %) died from the primary cancer, 11,062 (5.9 %) from non-cancer causes, and 929 (0.5 %) from other malignancies. Although cancer remained the predominant cause of death, non-cancer mortality increased over time (from 6.3 % in 2010 to 9.5 % in 2021). Cardiovascular disease, COPD, and cerebrovascular events were the most common non-cancer causes. The greatest excess mortality was observed for HIV-related infection conditions (SMR: 13.24), septicemia (10.60), suicide (6.68), and pneumonia/influenza (6.04).

Conclusion

Non-cancer mortality is an increasingly important contributor to death among patients with bone metastases, underscoring the need for targeted prevention strategies for infections, cardiovascular disease, and other avoidable causes in this vulnerable population.

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骨转移患者癌症和非癌症死亡率的综合分析：一项基于人群的研究

目的分析骨转移患者的死亡原因，并为该人群的生存规划和临床决策提供数据驱动的方法。方法：使用SEER登记（2010-2021）的数据，我们确定了186404例新诊断的骨转移患者。死亡原因分为癌症特异性、非癌症和继发癌症。计算标准化死亡率（SMRs）以评估相对于一般人群的超额非癌症死亡率。结果随访期间，133393例（71.5%）患者死于原发肿瘤，11062例（5.9%）患者死于非癌性原因，929例（0.5%）患者死于其他恶性肿瘤。虽然癌症仍然是主要死亡原因，但非癌症死亡率随着时间的推移而增加（从2010年的6.3%增加到2021年的9.5%）。心血管疾病、慢性阻塞性肺病和脑血管事件是最常见的非癌症原因。hiv相关感染（SMR: 13.24）、败血症（10.60）、自杀（6.68）和肺炎/流感（6.04）的超额死亡率最高。结论：非癌症死亡率是骨转移患者死亡的一个日益重要的因素，这强调了在这一脆弱人群中有针对性地预防感染、心血管疾病和其他可避免原因的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.