Department of Traumatology and Orthopedics, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China.
J Int Med Res. 2021 Sep;49(9):3000605211047771. doi: 10.1177/03000605211047771.
To identify risk factors and develop predictive web-based nomograms for the early death of patients with bone metastasis of lung adenocarcinoma (LUAD).
Patients in the Surveillance, Epidemiology, and End Results database diagnosed with bone metastasis of LUAD between 2010 and 2016 were included and randomly divided into training and validation sets. Early death-related risk factors (survival time ≤7 months) were evaluated by logistic regression. Two predictive nomograms were established and validated by calibration curves, receiver operating characteristic curves, and decision curve analysis.
A total of 9189 patients (56.59%) died from all causes within 7 months of being diagnosed, including 8585 patients (56.67%) who died from cancer-specific causes. Age >65 years, sex (men), T stage (T3 and T4), N stage (N2 and N3), brain metastasis, and liver metastasis were risk factors for all-cause and cancer-specific early death. The area under the curves of the nomograms for all-cause and cancer-specific early death prediction were 0.754 and 0.753 (training set) and 0.747 and 0.754 (validation set), respectively. Further analysis showed that the two nomograms performed well.
Our two web-based nomograms for all-cause and cancer-specific early death provide valuable tools for predicting early death in these patients.
确定肺腺癌（LUAD）骨转移患者早期死亡的风险因素，并开发基于网络的预测列线图。
纳入 2010 年至 2016 年间在监测、流行病学和最终结果数据库中诊断为 LUAD 骨转移的患者，并将其随机分为训练集和验证集。通过逻辑回归评估与早期死亡相关的风险因素（生存时间≤7 个月）。通过校准曲线、接收者操作特征曲线和决策曲线分析建立和验证了两个预测列线图。
共有 9189 例（56.59%）患者在确诊后 7 个月内死于各种原因，其中 8585 例（56.67%）死于癌症相关原因。年龄>65 岁、性别（男性）、T 分期（T3 和 T4）、N 分期（N2 和 N3）、脑转移和肝转移是全因和癌症特异性早期死亡的危险因素。全因和癌症特异性早期死亡预测列线图的曲线下面积分别为 0.754（训练集）和 0.753（验证集）和 0.747（训练集）和 0.754（验证集）。进一步分析表明，这两个列线图表现良好。
我们的两个基于网络的全因和癌症特异性早期死亡预测列线图为预测这些患者的早期死亡提供了有价值的工具。
