Evaluation of prognostic scoring systems for bone metastases using single-center data

Shimada, Hirofumi; Setoguchi, Takao; Nakamura, Shunsuke; Yokouchi, Masahiro; Ishidou, Yasuhiro; Tominaga, Hiroyuki; Kawamura, Ichiro; Nagano, Satoshi; Komiya, Setsuro

doi:10.3892/mco.2015.637

Cited by 9 publications

(8 citation statements)

References 10 publications

(12 reference statements)

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“…To our knowledge, no previous studies have been conducted before comparing more than two prognostic systems for patients in the setting appendicular metastases. Shimada et al compared the Ratasvouri SSG scale with the original Katagiri score for 145 patients with both axial and appendicular metastatic disease in 2015 [21]. Of all six prognostic models analysed in the femoral MBD patient cohort, the PathFx score was consistently the most reliable for sufficient accuracy in survival estimation for all time periods (Table 5).…”

Section: Discussionmentioning

confidence: 99%

Prediction of survival after surgical management of femoral metastatic bone disease – A comparison of prognostic models

Meares

Badran²,

Dewar

2019

Journal of Bone Oncology

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Background Operative fixation for femoral metastatic bone disease is based on the principles of reducing pain and restoring function. Recent literature has proposed a number of prognostic models for appendicular metastatic bone disease. The aim of this study was to compare the accuracy of proposed soring systems in the setting of femoral metastatic bone disease in order to provide surgeons with information to determine the most appropriate scoring system in this setting. Methods A retrospective cohort analysis of patients who underwent surgical management of femoral metastatic bone disease at a single institution were included. A pre-operative predicted survival for all 114 patients was retrospectively calculated utilising the revised Katagiri model, PathFx model, SSG score, Janssen nomogram, OPTModel and SPRING 13 nomogram. Univariate and multivariate Cox regression proportional hazard models were constructed to assess the role of prognostic variables in the patient group. Area under the receiver characteristics and Brier scores were calculated for each prognostic model from comparison of predicted survival and actual survival of patients to quantify the accuracy of each model. Results For the femoral metastatic bone disease patients treated with surgical fixation, multivariate analysis demonstrated a number of pre-operative factors associated with survival in femoral metastatic bone disease, consistent with established literature. The OPTIModel demonstrated the highest accuracy at predicting 12-month (Area Under the Curve [AUC] = 0.79) and 24-month (AUC = 0.77) survival after surgical management. PathFx model was the most accurate at predicting 3-month survival (AUC = 0.70) and 6-month (AUC = 0.70) survival. The PathFx model was successfully externally validated in the femoral patient dataset for all time periods. Conclusions Among six prognostic models assessed in the setting of femoral metastatic bone disease, the present study observed the most accurate model for 3-month, 6-month, 12-month and 24-month survival. The results of this study may be utilised by the treating surgical team to determine the most accurate model for the required time period and therefore improve decision-making in the care of patients with femoral metastatic bone disease.

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Section: Discussionmentioning

confidence: 99%

Prediction of survival after surgical management of femoral metastatic bone disease – A comparison of prognostic models

Meares

Badran²,

Dewar

2019

Journal of Bone Oncology

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“…Metastases are the commonest of bone tumors. With improved treatment of the primary malignancy, the incidence of bone tumors is on the increasing trend [1]. Any tumor can cause metastasis to the bone, but the commonest sites of primary that metastasis to the bone are the breast, lung, prostate, kidney, and thyroid [2].…”

Section: Introductionmentioning

confidence: 99%

Skeletal Metastasis—an Epidemiological Study

Zacharia

Subramaniam

Joy

2017

Indian J Surg Oncol

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Metastasis is the commonest bone tumors. The commonest primary metastasis to the bone are the breast, lung, prostate, kidney, and thyroid. The bone is the third common site of metastatic disease, only the lung and the liver have higher metastatic rate than skeleton. We have no epidemiological studies conducted to evaluate the various aspects of skeletal metastasis like age, sex distribution, presentation, common sites of primary and associated secondary metastases, and investigation from Indian subcontinent. Here we are presenting the first epidemiological study of skeletal metastasis from our region. We have conducted a prospective descriptive study in the Departments of Orthopedics and Radiotherapy, Government Medical College, Kozhikode, during the period of 2007 to 2009. One hundred eleven patients were included in the study above the age of 30 years. Clinical examination and investigation were done on these patients. Skeletal metastasis commonly occurs in the fifth decade of life with modest male preponderance. In most of the cases, the primary site of malignancy was undetected at the time of presentation. Pain was the commonest presented complaint of the patient. The spine is the commonest site affected and the lung was the common site of primary metastasis. Most of the cases were detected by radiogram and confirmation was obtained by minimally invasive technique like FNAC or CNB.

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“…(1) Life expectancy: The Tokuhashi score was initially developed for the surgical treatment of spine metastasis and is also used to assess life expectancy with long bone metastasis. 19 2-year survival rate, while scores $7 carried a 27% of 6-month survival rate and only a 6% of 1year survival rate.…”

Section: Overall Assessment Of These Patientsmentioning

confidence: 93%

“…Life expectancy and performance status (PS) are factors of upmost importance to consider in the decision-making process because they can affect the eligibility of patients for adjuvant therapies:(1) Life expectancy: The Tokuhashi score was initially developed for the surgical treatment of spine metastasis and is also used to assess life expectancy with long bone metastasis. 19 Katagiri et al 20 prospectively studied 808 patients with skeletal metastasis who underwent nonsurgical (749 patients) versus surgical (59 patients) treatments and identified six significant prognostic factors for survival: the primary tumor (sarcomas are considered to have moderate growth or median survival time from 10 to 20 months), visceral or brain metastasis, abnormal laboratory results, poor PS, previous chemotherapy, and multiple skeletal metastases. A prognostic score ≤3 was associated with a 91% of 1-year survival rate and 78% of 2-year survival rate, while scores ≥7 carried a 27% of 6-month survival rate and only a 6% of 1-year survival rate.(2) PS: The PS describes the symptoms and functions regarding ambulatory status and need for care.…”

Section: Clinical Approachmentioning

confidence: 99%

Musculoskeletal Metastasis From Soft-tissue Sarcomas: A Review of the Literature

Pretell-Mazzini

Seldon

D’Amato

et al. 2022

J Am Acad Orthop Surg

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Soft-tissue sarcomas are a rare and extremely heterogeneous group of cancers, representing ,1% of all human malignancies. The lungs are the most common site of distant metastasis, followed by the bone, lymph nodes, liver, brain, and subcutaneous tissue. Clinical experience suggests that skeletal metastasis is part of the natural history affecting the prognosis and quality of life in these patients. Approximately 2.2% of patients have skeletal metastasis at diagnosis. However, up to 10% will develop skeletal metastasis after a mean interval of 21.3 months. Although systemic therapy with conventional chemotherapy remains the primary treatment modality for those with metastatic sarcoma, increased survival has been achieved in selected patients who receive multimodality therapy, including surgery, for their metastatic disease. The 5-year overall survival of patients with isolated bone metastases was 41.2% (26.9% to 54.9%), which decreased to 32.9% (21.2% to 45.1%) in the setting of combined bone and lung metastases. Moreover, the resection of the primary soft-tissue sarcoma is a predictor of survival, resulting in a 58% decrease in mortality after surgery (hazard ratio, 0.42, P = 0.013). Understanding the effect of these metastases on patient survival may influence imaging, surveillance, and treatment decisions. Soft-tissue sarcomas (STSs) are a rare, extremely heterogeneous group of cancers, representing ,1% of human malignancies, 1,2 with an estimated 13,460 new cases in the United States in 2020. 3 At initial diagnosis, most patients with STS have no detectable distant disease 2 ; however, almost 50% of patients can potentially develop metastases to other organs, especially within 3 years of diagnosis. 4 Generally, these tumors have a propensity for hematogenous dissemination, 5 and the lungs are the most common site of distant metastasis, followed by the bone, lymph nodes, liver, brain, and subcutaneous tissue. 5 Musculoskeletal metastasis from STS and its clinical implications have received little attention, although clinical experience suggests that they are a late part of the natural history, representing a terminal stage of disease. 1,5

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Evaluation of prognostic scoring systems for bone metastases using single-center data

Cited by 9 publications

References 10 publications

Prediction of survival after surgical management of femoral metastatic bone disease – A comparison of prognostic models

Prediction of survival after surgical management of femoral metastatic bone disease – A comparison of prognostic models

Skeletal Metastasis—an Epidemiological Study

Musculoskeletal Metastasis From Soft-tissue Sarcomas: A Review of the Literature

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