title: Prognostic factors and a scoring system for patients with skeletal metastasis.
abstract: Between 1992 and 1999, we treated 350 patients with skeletal metastases. A multivariable analysis of the patients was conducted using the Cox proportional hazards model. We identified five significant prognostic factors for survival, namely, the site of the primary lesion, the performance status (Eastern Cooperative Oncology Group status 3 or 4), the presence of visceral or cerebral metastases, any previous chemotherapy, and multiple skeletal metastases. The score for each significant factor was derived from the corresponding estimated regression coefficients (natural logarithm of the hazard ratio). The prognostic score was calculated by adding all the scores for individual factors. The rate of survival was 31% at six months and 11% at one year for the patients with a prognostic score of 6 or more. By contrast, patients with a prognostic score of 2 or less had a rate of survival of 98% at six months and 89% at one year. This scoring system can be used to determine the optimal treatment for patients with pathological fractures or epidural compression.
authors.affiliation: Division of Orthopaedic Oncology, Shizuoka Cancer Center Hospital, Sunto-gun, Shizuoka 411-8777, Japan. h.katagiri@scchr.jp
authors.forename: H
authors.initials: H
authors.lastname: Katagiri
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: K
authors.initials: K
authors.lastname: Wakai
authors.forename: H
authors.initials: H
authors.lastname: Sugiura
authors.forename: T
authors.initials: T
authors.lastname: Kataoka
authors.forename: K
authors.initials: K
authors.lastname: Nakanishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents