Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis
ABSTRACT Background Bone metastases are highly refractory and are associated with extremely poor survival. Despite the increasing incidence of bone metastasis in gastric cancer (GC), comprehensive analyses regarding the clinicopathological features, prognosis, and treatment of bone‐metastatic GC rem...
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| Format: | Article |
| Language: | English |
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Wiley
2025-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70781 |
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| author | Shiji Ren Yutao Wei Wenqi Liu Yipeng Zhang Yue Wang Ju Yang Baorui Liu Tao Shi Jia Wei |
| author_facet | Shiji Ren Yutao Wei Wenqi Liu Yipeng Zhang Yue Wang Ju Yang Baorui Liu Tao Shi Jia Wei |
| author_sort | Shiji Ren |
| collection | DOAJ |
| description | ABSTRACT Background Bone metastases are highly refractory and are associated with extremely poor survival. Despite the increasing incidence of bone metastasis in gastric cancer (GC), comprehensive analyses regarding the clinicopathological features, prognosis, and treatment of bone‐metastatic GC remain limited. Methods We obtained data from 120 bone‐metastatic GC patients from Nanjing Drum Tower Hospital and 36,139 GC patients from the SEER database. Chi‐square and Mann–Whitney U‐tests evaluated clinicopathological features, while Cox models identified prognostic factors. Kaplan–Meier curves and forest plots assessed the effects of different treatment strategies on overall survival after bone metastasis (OS‐BM). Results Among 120 bone‐metastatic GC patients, 55 (45.83%) were diagnosed with poorly cohesive gastric carcinoma (PCC). The higher incidence of bone metastasis was also observed in SRCC patients from the SEER database (p < 0.0001). PCC patients exhibited distinct pathological features compared to non‐PCC patients, including lower PD‐L1 (p = 0.042) and E‐cadherin expression (p = 0.049). Multivariate analysis identified various negative prognostic factors such as metachronous bone metastasis (p < 0.001, HR = 2.35, 95% CI:1.47–3.74) and CA125 expression (p = 0.036, HR = 1.60, 95% CI:1.03–2.48), whereas immunotherapy was a positive prognostic factor (p < 0.001, HR = 0.44, 95% CI:0.29–0.66). Subgroup analysis also showed improved survival among different populations of bone‐metastatic GC patients receiving immunotherapy. Moreover, combinational therapies including immunotherapy and other treatments (anti‐angiogenic therapy and/or local radiotherapy) further improved patient OS‐BM. Conclusion Our results suggest bone‐metastatic GC patients exhibit distinct clinicopathological features, with a high incidence of bone metastasis in PCC. Immunotherapy‐based combination therapies offer improved survival benefits, thus supporting the application of immunotherapy in GC patients at high risk of bone metastasis. |
| format | Article |
| id | doaj-art-c6f140e0fd264b3f9ab77bbedbbb9e2b |
| institution | DOAJ |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-c6f140e0fd264b3f9ab77bbedbbb9e2b2025-08-20T03:10:39ZengWileyCancer Medicine2045-76342025-03-01146n/an/a10.1002/cam4.70781Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective AnalysisShiji Ren0Yutao Wei1Wenqi Liu2Yipeng Zhang3Yue Wang4Ju Yang5Baorui Liu6Tao Shi7Jia Wei8Department of Oncology Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDepartment of Oncology Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaABSTRACT Background Bone metastases are highly refractory and are associated with extremely poor survival. Despite the increasing incidence of bone metastasis in gastric cancer (GC), comprehensive analyses regarding the clinicopathological features, prognosis, and treatment of bone‐metastatic GC remain limited. Methods We obtained data from 120 bone‐metastatic GC patients from Nanjing Drum Tower Hospital and 36,139 GC patients from the SEER database. Chi‐square and Mann–Whitney U‐tests evaluated clinicopathological features, while Cox models identified prognostic factors. Kaplan–Meier curves and forest plots assessed the effects of different treatment strategies on overall survival after bone metastasis (OS‐BM). Results Among 120 bone‐metastatic GC patients, 55 (45.83%) were diagnosed with poorly cohesive gastric carcinoma (PCC). The higher incidence of bone metastasis was also observed in SRCC patients from the SEER database (p < 0.0001). PCC patients exhibited distinct pathological features compared to non‐PCC patients, including lower PD‐L1 (p = 0.042) and E‐cadherin expression (p = 0.049). Multivariate analysis identified various negative prognostic factors such as metachronous bone metastasis (p < 0.001, HR = 2.35, 95% CI:1.47–3.74) and CA125 expression (p = 0.036, HR = 1.60, 95% CI:1.03–2.48), whereas immunotherapy was a positive prognostic factor (p < 0.001, HR = 0.44, 95% CI:0.29–0.66). Subgroup analysis also showed improved survival among different populations of bone‐metastatic GC patients receiving immunotherapy. Moreover, combinational therapies including immunotherapy and other treatments (anti‐angiogenic therapy and/or local radiotherapy) further improved patient OS‐BM. Conclusion Our results suggest bone‐metastatic GC patients exhibit distinct clinicopathological features, with a high incidence of bone metastasis in PCC. Immunotherapy‐based combination therapies offer improved survival benefits, thus supporting the application of immunotherapy in GC patients at high risk of bone metastasis.https://doi.org/10.1002/cam4.70781bone metastasisgastric cancerimmunotherapypoorly cohesiveprognosis |
| spellingShingle | Shiji Ren Yutao Wei Wenqi Liu Yipeng Zhang Yue Wang Ju Yang Baorui Liu Tao Shi Jia Wei Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis Cancer Medicine bone metastasis gastric cancer immunotherapy poorly cohesive prognosis |
| title | Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis |
| title_full | Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis |
| title_fullStr | Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis |
| title_full_unstemmed | Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis |
| title_short | Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis |
| title_sort | clinical characteristics prognostic factors and therapeutic strategies in gastric cancer patients with bone metastasis a retrospective analysis |
| topic | bone metastasis gastric cancer immunotherapy poorly cohesive prognosis |
| url | https://doi.org/10.1002/cam4.70781 |
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