Fan Zhiyi, Huang Zhangheng, Huang Xiaohui
Hangzhou Medical College, Hangzhou, Zhejiang Province, China.
Department of Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, China.
J Oncol. 2021 May 12;2021:5575295. doi: 10.1155/2021/5575295. eCollection 2021.
Bone metastasis (BM) is one of the common sites of renal cell carcinoma (RCC), and patients with BM have a poorer prognosis. We aimed to develop two nomograms to quantify the risk of BM and predict the prognosis of RCC patients with BM.
We reviewed patients with diagnosed RCC with BM in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. Multivariate logistic regression analysis was used to determine independent factors to predict BM in RCC patients. Univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors for BM in RCC patients. Two nomograms were established and evaluated by calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA).
The study included 37,554 patients diagnosed with RCC in the SEER database, 537 of whom were BM patients. BM's risk factors included sex, tumor size, liver metastasis, lung metastasis, brain metastasis, N stage, T stage, histologic type, and grade in RCC patients. Currently, independent prognostic factors for RCC with BM included grade, histologic type, N stage, surgery, brain metastasis, and lung metastasis. The calibration curve, ROC curve, and DCA showed good performance for diagnostic and prognostic nomograms.
Nomograms were established to predict the risk of BM in RCC and the prognosis of RCC with BM, separately. These nomograms strengthen each patient's prognosis-based decision making, which is critical in improving the prognosis of patients.
骨转移（BM）是肾细胞癌（RCC）常见转移部位之一，发生骨转移的患者预后较差。我们旨在开发两个列线图，以量化骨转移风险并预测RCC骨转移患者的预后。
我们回顾了2010年至2015年监测、流行病学和最终结果（SEER）数据库中诊断为RCC并伴有骨转移的患者。采用多因素logistic回归分析确定RCC患者骨转移的独立预测因素。采用单因素和多因素Cox比例风险回归分析确定RCC骨转移患者的独立预后因素。建立了两个列线图，并通过校准曲线、受试者操作特征（ROC）曲线和决策曲线分析（DCA）进行评估。
该研究纳入了SEER数据库中37554例诊断为RCC的患者，其中537例为骨转移患者。骨转移的危险因素包括RCC患者的性别、肿瘤大小、肝转移、肺转移、脑转移、N分期、T分期、组织学类型和分级。目前，RCC骨转移的独立预后因素包括分级、组织学类型、N分期、手术、脑转移和肺转移。校准曲线、ROC曲线和DCA显示诊断和预后列线图性能良好。
建立列线图分别预测RCC骨转移风险和RCC骨转移患者的预后。这些列线图加强了基于每位患者预后的决策制定，这对改善患者预后至关重要。
