Department of Orthopaedics and Traumatology, Viransehir State Hospital, Şanlıurfa, Turkey.
Department of Orthopaedics and Traumatology, Çukurova University, Adana, Turkey.
Acta Orthop Traumatol Turc. 2024 Jan;58(1):62-67. doi: 10.5152/j.aott.2024.23132.
This study aimed to investigate the factors affecting the survival of patients with bone carcinoma metastases and assess the clinical applicability of existing prognostic models.
We retrospectively evaluated 247 patients who presented to our hospital between 2011 and 2021 diagnosed with bone carcinoma metastasis. Demographic data, general health status, primary diagnoses, laboratory and radiological findings, pathological fracture status, treatment methods, and survival times of the patients were recorded, and the effects of these variables on survival time were evaluated. Previously developed Katagiri, Janssen, 2013-Spring, PathFX, and SORG prognostic models were applied, and the predictive performances of these models were evaluated by comparing the predicted survival time with the actual survival time of our patients.
After the multivariate analysis, the following factors were shown to be significantly associated with the survival time of patients: blood hemoglobin and leukocyte levels, lactate dehydrogenase concentration, prognostic nutritional index, body mass index, performance status, medium and fast-growing groups of primary tumors, presence of extraspinal and visceral or brain metastases, and pathological fractures. According to receiver operating characteristics and Brier scores, SORG had the overall highest performance scores, while the Janssen nomogram had the lowest.
Our report showed that all prognostic models were clinically applicable, but their performances varied. Among them, the SORG predictive model had the best performance scores overall and is the model the authors suggested for survival prediction among patients with carcinoma bone metastases.
Level IV, Prognostic Study.
本研究旨在探讨影响骨癌转移患者生存的因素，并评估现有预后模型的临床适用性。
我们回顾性评估了 2011 年至 2021 年期间在我院就诊的 247 例骨癌转移患者。记录了患者的人口统计学数据、一般健康状况、原发诊断、实验室和影像学检查结果、病理性骨折状况、治疗方法和生存时间，并评估了这些变量对生存时间的影响。应用了先前开发的 Katagiri、Janssen、2013-Spring、PathFX 和 SORG 预后模型，并通过比较预测的生存时间与患者的实际生存时间来评估这些模型的预测性能。
多因素分析后，以下因素与患者生存时间显著相关：血血红蛋白和白细胞水平、乳酸脱氢酶浓度、预后营养指数、体重指数、体力状态、中速生长和快速生长的原发肿瘤组、存在脊柱外和内脏或脑转移以及病理性骨折。根据接收者操作特征和 Brier 评分，SORG 的总体性能评分最高，而 Janssen 列线图的评分最低。
我们的报告表明，所有预后模型均具有临床适用性，但性能有所不同。其中，SORG 预测模型总体性能评分最佳，是作者建议用于预测骨癌转移患者生存的模型。
IV 级，预后研究。
