title: A prediction model of survival for patients with bone metastasis from uterine cervical cancer.
abstract: OBJECTIVE
  The aim of the study was to establish a predictive model of survival period after bone metastasis from cervical cancer.
  
  
  METHODS
  A total of 54 patients with bone metastasis from cervical cancer were included in the study. Data at the time of bone metastasis diagnosis, which included presence of extraskeletal metastasis, performance status, history of any previous radiation or chemotherapy, the number of bone metastases, onset period, and treatment were collected. Survival data were analyzed using Kaplan-Meier method and Cox proportional hazards model.
  
  
  RESULTS
  The median survival period after diagnosis of bone metastasis was 22 weeks (5 months). The 26- and 52-week survival rates after bone metastasis were 36.5% and 15.4%, respectively. Cox regression analysis showed that extraskeletal metastasis (hazard ratio [HR], 6.1; 95% CI, 2.2 to 16.6), performance status of 3 to 4 (HR, 7.8; 95% CI, 3.3 to 18.2), previous radiation or chemotherapy (HR, 3.3; 95% CI, 1.4 to 7.8), multiple bone metastases (HR, 1.9; 95% CI, 1.0 to 3.5), and a bone metastasis-free interval of <12 months (HR, 2.5; 95% CI, 1.2 to 5.3) were significantly and independently related to poor survival. A prognostic score was calculated by adding the number of each significant factor. The 26-week survival rates after diagnosis of bone metastasis were 70.1% in the group with a score ≤2, 46.7% in the group with a score of 3, and 12.5% in the group with a score ≥4 (p<0.001).
  
  
  CONCLUSIONS
  This scoring system provided useful prognostic information on survival of patients with bone metastasis of cervical cancer.
authors.affiliation: Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Hiroko
authors.identifier: http://orcid.org/0000-0003-1496-214X
authors.initials: H
authors.lastname: Matsumiya
authors.affiliation: Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan. yukiharu@sap-cc.go.jp.
authors.forename: Yukiharu
authors.identifier: http://orcid.org/0000-0001-8692-4789
authors.initials: Y
authors.lastname: Todo
authors.affiliation: Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Kazuhira
authors.identifier: http://orcid.org/0000-0003-3678-6669
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Sho
authors.identifier: http://orcid.org/0000-0002-5484-7309
authors.initials: S
authors.lastname: Takeshita
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: Hiroyuki
authors.identifier: http://orcid.org/0000-0001-8759-9607
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Katsushige
authors.identifier: http://orcid.org/0000-0001-6020-9496
authors.initials: K
authors.lastname: Yamashiro
authors.affiliation: Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Hidenori
authors.identifier: http://orcid.org/0000-0002-2153-5843
authors.initials: H
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy
keywords: Bone Metastasis; Performance Status; Prognosis; Uterine Cervical Neoplasms