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New Model Stratifies Patients With Long Bone Metastases

Model includes four prognostic categories with clinical consequences to predict median survival

WEDNESDAY, Feb. 14, 2018 (HealthDay News) — A model with four categories has been developed to stratify patients with symptomatic long bone metastases (LBM) based on their expected survival, according to an article published online Feb. 7 in the Journal of Bone & Joint Surgery.

Julie J. Willeumier, M.D., from the Leiden University Medical Centre in the Netherlands, and colleagues conducted a multicenter retrospective study of 1,520 patients treated for symptomatic LBM between 2000 and 2013. Using an existing classification system, primary tumors were categorized into favorable, moderate, or unfavorable clinical profiles.

The researchers found that the median overall survival was 7.4 months. Twelve prognostic categories were created based on the independent prognostic factors: the clinical profile, Karnofsky Performance Score, and presence of visceral and/or brain metastases. The discriminatory ability, assessed with the Harrell C-statistic, was 0.70. To easily stratify patients, a flowchart was developed. The 12 categories were narrowed to four categories with clinical consequences using cutoff points for clinical decision making. For the four categories, median survival was 21.9, 10.5, 4.6, and 2.2 months, respectively.

“This study presents a model to easily stratify patients with symptomatic LBM according to their expected survival,” the authors write. “The simplicity and clarity of the model facilitate and encourage its use in the routine care of patients with LBM, to provide the most appropriate treatment for each individual patient.”

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