The following is a summary of “Establishment and validation of a nomogram for predicting overall survival of upper-tract urothelial carcinoma with bone metastasis: a population-based study,” published in the April 2024 issue of Urology by Hu et al.
Bone metastasis presents a significant challenge in the prognosis of patients with upper-tract urothelial carcinoma (UTUC), often leading to poor outcomes. This study aimed to delve into survival predictors and construct a prognostic nomogram tailored for overall survival (OS) among patients with UTUC patients with bone metastasis (BM).
In this investigation, data from the Surveillance, Epidemiology, and End Results (SEER) database spanning 2010 to 2019 were utilized to identify and analyze UTUC patients with BM. Baseline differences among groups were assessed using the chi-square test, while OS was evaluated through Kaplan–Meier analysis. Both univariate and multivariate analyses were conducted to pinpoint prognostic factors essential for establishing the nomogram. Additionally, an independent cohort served for external validation purposes. The performance of the nomogram was then assessed in terms of discrimination and calibration using metrics such as concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). Statistical analyses were carried out using SPSS 23.0 and R software 4.2.2.
Results showcased a mean OS of 10 months (95% CI: 8.17 to 11.84) for UTUC patients with BM, with 6-month, 1-year, and 3-year OS rates of 41%, 21%, and 3%, respectively. Multi-organ metastases emerged as a significant independent prognostic factor (HR = 2.21, 95% CI: 1.66 to 2.95, P < 0.001), alongside surgery (HR = 0.72, 95% CI: 0.56 to 0.91, P = 0.007) and chemotherapy (HR = 0.37, 95% CI: 0.3 to 0.46, P < 0.001), which were identified as protective factors. The developed nomogram exhibited robust performance with a C-index of 0.725 for the training cohort and 0.854 for the validation cohort, with all AUC values surpassing 0.679. Calibration and DCA curves further demonstrated the nomogram’s accuracy and practicality.
In conclusion, the study underscores the challenging prognosis UTUC patients with BM. By building and validating a nomogram, clinicians are equipped with a valuable tool for evaluating OS in this specific patient population, aiding in clinical decision-making and patient management.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01488-7