Hirohisa Katagiri1, Rieko Okada2, Tatsuya Takagi1, M Takahashi1, Hideki Murata1, Hideyuki Harada3, Tetsuo Nishimura3, Hirofumi Asakura3, Hirofumi Ogawa3
1Division of Orthopaedic Oncology Shizuoka Cancer Center Hospital Nagaizumi Shizuoka Japan
2Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
3Division of Radiation Oncology, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
Tóm tắt
AbstractThe aim of this study was to update a previous scoring system for patients with skeletal metastases, that was proposed by Katagiri et al. in 2005, by introducing a new factor (laboratory data) and analyzing a new patient cohort. Between January 2005 and January 2008, we treated 808 patients with symptomatic skeletal metastases. They were prospectively registered regardless of their treatments, and the last follow‐up evaluation was performed in 2012. There were 441 male and 367 female patients with a median age of 64 years. Of these patients, 749 were treated nonsurgically while the remaining 59 underwent surgery for skeletal metastasis. A multivariate analysis was conducted using the Cox proportional hazards model. We identified six significant prognostic factors for survival, namely, the primary lesion, visceral or cerebral metastases, abnormal laboratory data, poor performance status, previous chemotherapy, and multiple skeletal metastases. The first three factors had a larger impact than the remaining three. The prognostic score was calculated by adding together all the scores for individual factors. With a prognostic score of ≥7, the survival rate was 27% at 6 months, and only 6% at 1 year. In contrast, patients with a prognostic score of ≤3 had a survival rate of 91% at 1 year, and 78% at 2 years. Comparing the revised system with the previous one, there was a significantly lower number of wrongly predicted patients using the revised system. This revised scoring system was able to predict the survival rates of patients with skeletal metastases more accurately than the previous system and may be useful for selecting an optimal treatment.
