Journal of Surgery Concepts & Practice ›› 2018, Vol. 23 ›› Issue (02): 158-165.doi: 10.16139/j.1007-9610.2018.02.016

• Original article • Previous Articles     Next Articles

Risk factors analysis of skeletal-related events in breast cancer patients with bone metastases: a systematic review and retrospective analysis of 104 cases

HU Guangfu1, YANG Weige2, YANG Ziang2, WANG Hong2, ZHU Wei2, QIU Xiaochun3, ZHANG Hongwei2, YI Haiying1   

  1. 1. Department of Breast Surgery, Shanghai Huangpu District Central Hospital, 200002 Shanghai, China;
    2. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China;
    3. Library, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2017-12-06 Online:2018-03-25 Published:2020-07-25

Abstract: Objective To explore the risk factors of skeletal-related event(SRE) in breast cancer patients with bone metastases in order to provide clinical base for early prevention of SRE. Methods A systematic literature search from PubMed, Web of Science, CNKI, VIP and Wanfang Data was conducted for the study on risk factors of SRE in breast cancer patients with bone metastases published in Chinese or English between January 1 2000 and October 31 2017. Then relevant information and conclusion were extracted. A total of 104 breast cancer patients with bone metastases from April 2004 to December 2016 in Zhongshan Hospital Fudan University and Shanghai Huangpu District Central Hospital were followed up for SRE. The risk factors of SRE were analyzed. Results Six literatures met the inclusion criteria and were included, which provided univariable and/or multivariable analysis of the risk factors of SRE including patient age, ER/PR/HER2, histological/nuclear grade, clinical stage of disease, duration of bone metastases, number of bone metastases sites and type of surgery. Most studies supported later clinical stage, longer duration of bone metastases and more sites of bone metastases were risk factors of SRE although the conclusions of 6 literatures were different slightly. During median follow-up of 60 months, 58 of 104 cases occurred SRE. Both primary distant metastasis (P=0.017) and multiple bone metastases sites (P=0.008) were independent risk factors of SRE by univariable and multivariable analysis. Similar results were gotten in retrospective study and systematic review. Conclusions It was shown by systematic review and retrospective analysis with 104 cases that later clinical stages, longer duration of bone metastases and more bone metastases sites were probably the risk factors of SRE. Nevertheless, age, molecular classification of breast cancer, histological/nuclear grade or surgery type etc. were not necessarily related to SRE.

Key words: Breast cancer, Bone metastases, Skeletal-related event, Risk factors

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