J Cancer 2019; 10(14):3133-3139. doi:10.7150/jca.30335

Research Paper

The prevalence, associated factors for bone metastases development and prognosis in newly diagnosed ovarian cancer: a large population based real-world study

Chao Zhang1, Xu Guo1,6, Karl Peltzer3, Wenjuan Ma4, Lisha Qi5, Yanting Zhang1, Xiuxin Han1, Vladimir P. Baklaushev9, Yueliang Yao8, Guowen Wang1, Vladimir P. Chekhonin7, Xin Wang2✉, Yulin Ma1✉

1. Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
2. Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China.
3. Department of Research & Innovation, University of Limpopo, Turfloop, South Africa.
4. Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
5. Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
6. Department of Orthopedics, Cangzhou Central Hospital, Cangzhou, Hebei, China.
7. Department of Fundamental and Applied Neurobiology, V. P. Serbsky Federal Medical Research Center of Psychiatry and Narcology, the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
8. Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
9. Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation, Moscow, Russian Federation.

Abstract

Background: Ovarian cancer (OC) is one of the most common malignancies in women. Advanced bone metastases (BM) commonly result in the poor prognosis. We aim to evaluate the prevalence and associated factors for the de novo BM development and prognosis in OC.

Materials and methods: The present study was a cohort study that used the United States based National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. SEER documented OC patients, diagnosed between 2010 and 2015, were included in the present study. Univariable and multivariable logistic regression analyses were employed to identify associated factors for BM development. Kaplan-Meier analysis was used to estimate the overall survival and multivariable proportional hazard regression was used to identify the prognostic factors for OC patients with BM.

Results: A total of 32,178 eligible OC patients were included in the present study, the prevalence of de novo BM was 1.09% (N=352). Non-serous histology [Odds Ratio (OR)=3.05; 95% CI: 1.63-5.72; P=0.001], T2/T1 stage (OR=3.39; 95% CI: 1.11-10.33; P=0.03), N1/N0 stage (OR=3.17; 95% CI: 1.72-5.84; P<0.001), and the presence of lung (OR=8.57; 95% CI: 4.37-16.80; P<0.001) and liver metastases (OR=4.95; 95% CI: 2.50-9.82; P<0.001) were all significantly associated with de novo BM development. Median survival for OC with BM was 5.00 (95% CI: 3.76-6.24) months. Multivariable Cox regression showed serous histology [Hazard ratio (HR)=1.44; 95% CI: 1.01-2.06; P=0.046] was positively associated with overall death, while surgery of the primary site (HR=0.42; 95% CI: 0.29-0.61; P<0.001) was negatively associated with overall death.

Conclusion: Bone metastasis is rare in ovarian cancer patients. The factors associated with BM development and prognosis can be potentially used for BM early screening and individualized treatment.

Keywords: bone metastases, ovary cancer, associated factor, prognosis, SEER

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How to cite this article:
Zhang C, Guo X, Peltzer K, Ma W, Qi L, Zhang Y, Han X, Baklaushev VP, Yao Y, Wang G, Chekhonin VP, Wang X, Ma Y. The prevalence, associated factors for bone metastases development and prognosis in newly diagnosed ovarian cancer: a large population based real-world study. J Cancer 2019; 10(14):3133-3139. doi:10.7150/jca.30335. Available from http://www.jcancer.org/v10p3133.htm