Risk Factors for Bone Metastases at RCC Diagnosis Identified

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The incidence of bone metastases at initial diagnosis of RCC varies by histologic subtype, a study found.
The incidence of bone metastases at initial diagnosis of RCC varies by histologic subtype, a study found.

Older age, male sex, lymph node involvement, and higher T stage are among the risk factors for bone metastases at the initial diagnosis of renal cell carcinoma (RCC), according to investigators.

In a study of 45,824 patients newly diagnosed with RCC, 1509 (3.29%) had bone metastases at initial diagnosis, Qi Guo, MD, of the First Affiliated Hospital, Army Medical University, Chongqing, China, and colleagues reported recently in Cancer Management and Research. The incidence of bone metastases was 3.87%, 1.52%, 0.80%, and 18.1% among patients with clear-cell, papillary, chromophobe, and collecting duct RCC, respectively.

On multivariable analysis, older age, male sex, higher T stage, lymph node involvement, poor tumor grade, and the presence of lung, liver, or brain metastases were associated with significantly greater odds of bone metastases at diagnosis.

Compared with patients aged 40 years or younger, those aged 41–69 and 70 years or older had 1.9- and 1.6-fold increased odds of bone metastases at diagnosis, respectively. The odds of bone metastases at diagnosis were 25% higher among men than women, and 2.2-fold greater among patients who had lymph node involvement compared with those who did not. Compared with patients who had T1 disease, those with T2, T3, and T4 disease had 3.8-, 3.0-, and 2.8-fold increased odds of bone metastases, respectively.

The median survival time for RCC patients with bone metastases was 12 months, but this varied by RCC subtype. The median survival times for those with collecting duct, clear-cell, papillary, and chromophobe subtypes were 3, 13, 8, and 11 months, respectively. On multivariable analysis, patients with papillary and collecting duct RCC had a 1.8- and 2.1-fold increased risk of death, respectively, compared with patients who had clear-cell RCC.

Reference

Guo Q, Zhang C, Guo X, et al. Incidence of bone metastasis and factors contributing to its development and prognosis in newly diagnosed renal cell carcinoma: a population-based study. Cancer Manag Res. 2018;10:2935-2944.

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