PATHOLOGICAL FRACTURES DUE TO BONE METASTASES FROM LUNG CANCER: RISK FACTORS AND SURVIVAL.

INTRODUCTION

Pathological fractures are frequent skeletal-related events among lung cancer patients, which result in high morbidity and decreased overall survival and make operative treatment decisions challenging.

OBJECTIVES

To identify risk factors associated with the occurrence of pathological fractures in patients with lung cancer and to determine survival.

METHODS

We conducted a retrospective cohort study with 407 lung carcinoma patients diagnosed between 2006 and 2015. The prevalence of bone metastases and pathological fractures was calculated. Statistical analysis was conducted using a chi-squared test, and the odds ratio and 95% confidence interval were calculated. Overall survival was determined using the Kaplan-Meier method and differences were compared using the log-rank test.

RESULTS

The prevalence of bone metastases and pathological fractures was 28.2% (n = 115) and 19.1% (n = 22), respectively. Pathological fractures were more frequent among patients with bone metastases at the time of diagnosis of lung cancer (24.7% [n = 20] vs. 5.9% [n = 2]; p < 0.05). The median overall survival following the diagnosis of lung cancer, bone metastases, and pathological fracture was 6, 4, and 2 months, respectively.

CONCLUSIONS

Pathological fracture was associated with synchronous bone metastases and overall survival times were considerably reduced. Level of Evidence IV, Case Series.