Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2024; 12(15): 2499-2505
Published online May 26, 2024. doi: 10.12998/wjcc.v12.i15.2499
Recent trends in bone metastasis treatments: A historical comparison using the new Katagiri score system
Kenji Matsuda, Kazuhiro Shimazu, Hanae Shinozaki, Koji Fukuda, Taichi Yoshida, Daiki Taguchi, Kyoko Nomura, Hiroyuki Shibata
Kenji Matsuda, Kazuhiro Shimazu, Hanae Shinozaki, Koji Fukuda, Taichi Yoshida, Daiki Taguchi, Hiroyuki Shibata, Department of Clinical Oncology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
Kyoko Nomura, Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan
Hiroyuki Shibata, Department of Comprehensive Cancer Control, Akita University Graduate School of Medicine, Akita 010-8543, Japan
Co-first authors: Kenji Matsuda and Kazuhiro Shimazu.
Author contributions: Matsuda K and Shimazu K contributed equally to this work as co-first authors; Matsuda K, Shimazu K, Shinozaki H, Fukuda K, Yoshida T, Taguchi D and Shibata H treated the patients; Matsuda K and Shimazu K collected and analyzed the data; Nomura K confirmed the statistical analyses; Shibata H overviewed this study and prepared the manuscript.
Institutional review board statement: This study was certified and approved by the Ethics Committees of Akita University (No. 2814).
Informed consent statement: Written informed Consent for Publication of case could not be obtained from all participants. Instead, notification about the purpose and the implementation of the research was made public and an "opt-out" system was implemented to guarantee the opportunity to refuse as much as possible.
Conflict-of-interest statement: No author has any conflict of interest concerning this publication.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hiroyuki Shibata, MD, PhD, Professor, Department of Clinical Oncology, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita 010-8543, Japan. hiroyuki@med.akita-u.ac.jp
Received: December 10, 2023
Revised: April 6, 2024
Accepted: April 15, 2024
Published online: May 26, 2024
Processing time: 155 Days and 20.4 Hours
Abstract
BACKGROUND

Bone metastasis has various negative impacts. Activities of daily living (ADL) and quality of life (QOL) can be significantly decreased, survival may be impacted, and medical expenses may increase. It is estimated that at least 5% cancer patients might be suffering from bone metastases. In 2016, we published the Comprehensive Guidelines for the Diagnosis and Treatment of Bone Metastasis. Since then, the therapeutic outcomes for patients have gradually improved. As life expectancy is a major determinant of surgical intervention, the strategy should be modified if the prolongation of survival is to be achieved.

AIM

To monitor how bone metastasis treatment has changed before and after launch of our guidelines for bone metastasis.

METHODS

For advanced cancer patients with bone metastasis who visited the Department of Clinical Oncology at Akita University hospital between 2012 and 2023, parameters including the site and number of bone metastases, laboratory data, and survival time, were extracted from electronic medical records and the Katagiri score was calculated. The association with survival was determined for each factor.

RESULTS

Data from 136 patients were obtained. The 1-year survival rate for the poor prognosis group with a higher Katagiri score was 20.0% in this study, which was 6% and an apparent improvement from 2014 when the scoring system was developed. Other factors significantly affecting survival included five or more bone metastases than less (P = 0.0080), and treatment with chemotherapy (P < 0.001), bone modifying agents (P = 0.0175) and immune checkpoint inhibitors (P = 0.0128). In recent years, advances in various treatment methods have extended the survival period for patients with advanced cancer. It is necessary not only to simply extend survival time, but also to maintain ADL and improve QOL.

CONCLUSION

Various therapeutic interventions including surgical approach for bone metastasis, which is a disorder of locomotor organs, are increasingly required. Guidelines and scoring system for prognosis need to be revised promptly.

Keywords: Bone metastasis, New Katagiri scoring system, Prognosis, Immune check point inhibitors, Survival

Core Tip: We investigated bone metastasis patients from 2012 to 2023 at Department of Clinical Oncology, Akita University Hospital to learn about recent trends in treatment methods and outcomes for patients with bone metastases. The prognosis of patients with bone metastases has improved recently. Now, there is a room for surgical interventions to the patients with bone metastases, which have been avoided due to their limited prognosis. These are expected to improve activities of daily living and quality of life and will benefit patients. Accordingly, guidelines and scoring system for prognosis need to be revised.