黑色素瘤患者骨转移和骨骼相关事件的发生率、风险因素和存活率:29 项研究的系统回顾与质量评估

IF 3.4 2区 医学 Q2 Medicine
Michelle R. Shimizu , Olaf N. van de Langerijt , Daniel Torres , Tom de Groot , Olivier Q. Groot
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引用次数: 0

摘要

背景骨骼转移占晚期黑色素瘤转移的17%。由于骨转移与骨骼相关事件(SREs)有关,包括病理性骨折、脊髓压迫、高钙血症、放疗和手术,因此会增加发病率和死亡率,降低生活质量。该研究旨在确定黑色素瘤骨转移和SRE的发生率,识别发生骨转移和SRE的可能风险因素,并调查这一患者群体的生存率。方法使用Pubmed、Embase和Cochrane Central Register of Controlled Trials对截至2023年7月的文献进行计算机检索。采用纽卡斯尔-渥太华质量评估量表(NOS)进行质量评估。记录了研究特点、患者信息、发生骨转移和SRE的风险因素以及生存特点。无骨转移的平均间隔时间从 4 个月到 72 个月不等。14项研究的骨转移发生率从2%到49%不等。69%的研究(20/29)描述了骨转移的部位,其中24%的研究(7/29)仅关注脊柱转移。在一项研究中,71%(59/83)的患者队列中记录了 129 例 SRE,表现各异。使用骨导向药物与较低的骨转移风险密切相关。发现骨转移后的存活期从3个月到13个月不等。本综述强调了黑色素瘤患者发生骨转移及随后发生SRE的显著发病率和风险因素。骨转移的激增给并发症的处理带来了挑战,因为SRE的发病率很高。本研究全面概述了黑色素瘤患者骨转移和SRE的发病率、风险因素和相关结果,可为患者和医生的决策提供指导,但现有文献中的高质量数据有限,设计也不尽相同,这是一个值得注意的不足之处。未来的研究应探讨黑色素瘤骨转移和SRE的预测因素,以帮助患者和医生做出决策,并最终改善这一患者群体的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Incidence, Risk Factors, and Survival of Bone Metastases and Skeletal-Related Events in Melanoma Patients: A Systematic Review and Quality Assessment of 29 Studies

Incidence, Risk Factors, and Survival of Bone Metastases and Skeletal-Related Events in Melanoma Patients: A Systematic Review and Quality Assessment of 29 Studies

Background

Skeletal metastases make up 17% of all metastases from advanced-stage melanoma. Bone metastases are associated with increased morbidity and mortality and decreased quality of life due to their association with skeletal-related events (SREs), including pathological fracture, spinal cord compression, hypercalcemia, radiotherapy, and surgery. The study aimed to determine the incidence of bone metastases and SREs in melanoma, identify possible risk factors for the development of bone metastases and SREs, and investigate survival rates in this patient population.

Methods

A computer-based literature search was conducted using Pubmed, Embase, and Cochrane Central Register of Controlled Trials up to July 2023. The Newcastle-Ottawa Quality Assessment Scale (NOS) was utilized for quality assessment. Study characteristics, patient information, risk factors for developing bone metastases and SREs, and characteristics for survival were recorded.

Results

We included 29 studies. The average bone metastasis-free interval ranged from four to 72 months. Incidence of bone metastases varied from 2 % to 49 % across 14 studies. 69 % (20/29) of studies described the location of bone metastases, with 24 % (7/29) focusing solely on spinal metastases. In one study, 129 SREs were recorded in 71 % (59/83) of the patient cohort, with various manifestations. The use of bone-directed agents was independently associated with lower risk of SREs. Survival after detection of bone metastasis ranged from three to 13 months. Factors associated with survival included clinical, tumor-related, and treatment features.

Conclusion

This review highlights the notable prevalence and risk factors of developing bone metastases and subsequent SREs in patients with melanoma. The surge in bone metastases poses a challenge in complication management, given the high prevalence of SREs. While this study offers a comprehensive overview of the incidence, risk factors, and outcomes associated with bone metastases and SREs in melanoma patients that may guide patient and physician decision-making, a notable gap lies in the limited availability of high-quality data and the heterogeneous design of the existing literature. Future research should address predictive factors for bone metastases and SREs in melanoma to facilitate patient and physician decision-making and ultimately improve outcomes in this patient population.

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来源期刊
CiteScore
7.20
自引率
2.90%
发文量
50
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.
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