Journal of Bone Oncology最新文献

{"title":"Multimodal deep learning for bone tumor diagnosis with clinical imaging, pathology, and blood biomarkers","authors":"Hang Sang ,&nbsp;Tao Lin ,&nbsp;Lincong Luo ,&nbsp;Mingrui Liu ,&nbsp;Jiaying Li ,&nbsp;Xiang Luo ,&nbsp;Jianlin Shen ,&nbsp;Shizhen Zhong ,&nbsp;Lin Xu ,&nbsp;Wenhua Huang","doi":"10.1016/j.jbo.2025.100718","DOIUrl":"10.1016/j.jbo.2025.100718","url":null,"abstract":"<div><div>Accurate classification of bone tumors as benign, malignant, or intermediate is crucial for patient treatment decisions. Misclassification may result in overtreatment of benign cases or delayed intervention for aggressive tumors, significantly impacting patient prognosis. However, current methods rely heavily on single-modality imaging analysis, making it difficult to handle variable lesion locations and complex cancer types. To address these limitations, we propose a novel multimodal deep learning framework that integrates clinical images, pathological slices, and blood biomarkers for automated bone tumor detection and three-class classification. The framework operates in two stages: first, a YOLOv5-based detection model localizes tumor regions on clinical images. Next, a classification model utilizes ResNet to extract deep features from both the clinical images and pathological slices, while abnormal blood biomarkers are transformed into descriptive text by a large language model and subsequently encoded into semantic features using BioBERT. Finally, features from all three modalities are integrated via a fusion module to capture complementary information and enable accurate tumor classification. The evaluation was performed using two distinct datasets: a clinical imaging dataset for bone tumor detection, and a separate multi-modal cohort comprising clinical imaging, pathology, and blood biomarkers for tumor classification. The detection model demonstrated strong localization capabilities, achieving a test [email protected] of 0.7925. For the classification task, ablation studies validated the complementary contribution of each modality. Notably, our multimodal fusion approach outperformed unimodal baselines, attaining a macro-average precision of 0.9056, F1-score of 0.8736, and AUC of 0.9759 in tumor classification—outperforming existing models.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"55 ","pages":"Article 100718"},"PeriodicalIF":3.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and comprehensive characterization of a subline with highly bone-metastatic propensity derived from the lung adenocarcinoma A549 cell line","authors":"Yujian Xu ,&nbsp;Yahan Qin ,&nbsp;Wenjun Chai ,&nbsp;Ke Xue ,&nbsp;Xiaoli Liu ,&nbsp;Jing Li ,&nbsp;Yue Cao ,&nbsp;Lei Sun ,&nbsp;Hongyu Pan ,&nbsp;Mingxia Yan","doi":"10.1016/j.jbo.2025.100719","DOIUrl":"10.1016/j.jbo.2025.100719","url":null,"abstract":"<div><div>Bone metastasis is a major cause of mortality in lung adenocarcinoma, but the mechanisms remain poorly understood. Here, we established a highly bone-metastatic subline, A549-BM5, from the A549 cell line through five rounds of <em>in vivo</em> selection. A549-BM5 cells exhibited enhanced migration and invasion, and preferentially colonized specific skeletal sites in mouse models. In the bone microenvironment, they promoted the recruitment and differentiation of osteoblasts and osteoclasts, disrupting bone homeostasis. Transcriptomic and proteomic profiling revealed dysregulation in pathways such as EMT, adhesion, and bone morphogenesis. We further applied a random forest model to identify potential therapeutic targets associated with bone metastasis. Compared to existing A549-based models, A549-BM5 offers earlier metastasis onset, stable bone tropism, and broader interaction with the bone niche. This model provides a valuable platform for mechanistic studies and therapeutic development targeting lung cancer bone metastasis.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"55 ","pages":"Article 100719"},"PeriodicalIF":3.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient increase in skeletal-related events after discontinuation of high-dose denosumab in cancer patients","authors":"Nokitaka Setsu ,&nbsp;Nobuhiko Yokoyama ,&nbsp;Taito Esaki ,&nbsp;Masafumi Yamaguchi ,&nbsp;Eriko Tokunaga ,&nbsp;Takahito Negishi","doi":"10.1016/j.jbo.2025.100717","DOIUrl":"10.1016/j.jbo.2025.100717","url":null,"abstract":"<div><h3>Background</h3><div>Denosumab is widely used to prevent skeletal-related events (SREs) in patients with bone metastases. However, rebound bone resorption after discontinuation is recognized. In osteoporosis, discontinuation of low-dose denosumab increases multiple vertebral fractures, but data on high-dose discontinuation remain limited.</div></div><div><h3>Methods</h3><div>Among 493 patients treated with high-dose denosumab at our institution (2014–2023), 78 met eligibility criteria. SREs during and after treatment were compared using each patient as their own control. SREs were defined as pathological fracture, spinal cord compression, or radiotherapy/surgery for metastatic bone pain. Hypercalcemia, benign fragility fractures, and serum ALP level were also assessed.</div></div><div><h3>Results</h3><div>A total of 11 SREs were observed during denosumab and 24 after discontinuation. Post-discontinuation incidence was 14.1 per 1,000 person-months, 3.3 times higher than during treatment (95 % CI, 1.4–7.8). The increase was significant at 6–15 months, peaking at 12–15 months (IRR 8.7, 95 % CI, 2.8–27.5), and declined thereafter. Fewer denosumab doses were also associated with a higher risk of SREs after discontinuation. Two benign fragility fractures occurred during denosumab and four after discontinuation. Grade ≥ 3 hypercalcemia occurred only after discontinuation (3 cases). Transient ALP elevation at 9–18 months was observed in patients with post-discontinuation SREs, and ALP ≥ 95 U/L at 6 months predicted subsequent SREs (AUC 0.80).</div></div><div><h3>Conclusion</h3><div>SREs increased significantly 6–15 months after high-dose denosumab discontinuation. Elevated ALP was associated with post-discontinuation SREs. These findings emphasize that discontinuation contributes to SRE risk, possibly via rebound bone resorption, and underscore the importance of continuation of therapy whenever possible.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"55 ","pages":"Article 100717"},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of prognostic models for bone metastasis in Non-Small cell lung cancer based on Machine learning algorithms","authors":"Jiabin Fang ,&nbsp;Xiaojie Yang ,&nbsp;Lingfeng Chen ,&nbsp;Liuying Hong ,&nbsp;Yingqiu He ,&nbsp;Ji Huang ,&nbsp;Jie Lin ,&nbsp;Nengluan Xu ,&nbsp;Hongru Li","doi":"10.1016/j.jbo.2025.100716","DOIUrl":"10.1016/j.jbo.2025.100716","url":null,"abstract":"<div><h3>Background</h3><div>Bone is a common site of metastasis in non-small cell lung cancer (NSCLC), yet no validated prognostic model is currently available for patients presenting with bone metastases at diagnosis.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 1,299 NSCLC patients who underwent high-throughput sequencing between 2016 and 2023. Of these, 195 were diagnosed with bone metastases at presentation. Three machine learning algorithms were applied to identify prognostic variables. A nomogram constructed with Cox regression was used to predict overall survival (OS) and was internally validated with 1,000 bootstrap resamples.</div></div><div><h3>Results</h3><div>Four independent prognostic factors were identified, including age, serum calcium, monocyte-to-albumin ratio, and prognostic nutritional index. The nomogram demonstrated strong predictive performance, with areas under the curve (AUCs) of 86.53%, 78.32%, and 77.85% for 6-month, 1-year, and 2-year OS, respectively. Calibration plots showed excellent agreement between predicted and observed survival outcomes.</div></div><div><h3>Conclusion</h3><div>This validated nomogram provides a practical and individualized tool for predicting survival in NSCLC patients with bone metastases at diagnosis, supporting risk stratification and clinical practice.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"55 ","pages":"Article 100716"},"PeriodicalIF":3.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the mechanism of osteosarcoma induced by long-term PET exposure: prediction from combined network toxicology, machine learning and molecular docking","authors":"Yu Qiao ,&nbsp;Fahu Yuan ,&nbsp;Anna Curto-Vilalta ,&nbsp;Rüdiger von Eisenhart-Rothe ,&nbsp;Florian Hinterwimmer","doi":"10.1016/j.jbo.2025.100714","DOIUrl":"10.1016/j.jbo.2025.100714","url":null,"abstract":"<div><h3>Objective</h3><div>Polyethylene terephthalate (PET) has emerged as a focal point in addressing global pollution and a critical environmental issue due to its potential health hazards. However, its role in the pathogenesis of osteosarcoma (OS) and the underlying molecular mechanisms remain largely unexplored, further highlighting the necessity of assessing its molecular toxicity.</div></div><div><h3>Methods</h3><div>This study integrated network toxicology, machine learning, molecular docking, and CIBERSORT-based immune infiltration analysis to systematically investigate the potential impact of PET exposure on contracting OS, elucidating its biological functions, signaling mechanisms, and immune microenvironment. Molecular docking was further applied to characterize the binding properties of PET with hub proteins, and potential therapeutic agents for OS were predicted.</div></div><div><h3>Results</h3><div>We identified 12 potential key targets of OS associated with PET exposure and, through machine learning models, selected six hub genes (i.e., BCAT1, CDK4, CSF1R, CXCR4, MYB, and PRTN3). Gene Ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analyses were conducted to elucidate the roles of these genes in biological processes, cellular components, molecular functions, and signaling pathways. Molecular docking results revealed that PET exhibits high specificity in binding to these hub genes, particularly by interacting with CSF1R (−8.312 kcal/mol), potentially activating the PI3K-Akt signaling pathway and modulating the OS immune microenvironment to promote tumor progression through multiple mechanisms. Furthermore, drug prediction analysis identified <em>p</em>-Benzoquinone and JNK-9L as potential therapeutic candidates for OS.</div></div><div><h3>Conclusion</h3><div>This study reveals that PET may play a critical role in OS development by regulating hub genes and signaling pathways. Molecular docking analysis demonstrates that PET can tightly bind to specific target proteins, suggesting a potential molecular mechanism underlying OS progression. These findings provide a scientific basis for further evaluating PET-related health risks and offer theoretical support for the development of future prevention and treatment strategies.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"55 ","pages":"Article 100714"},"PeriodicalIF":3.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alteration of bone architecture following androgen deprivation therapy in patients with prostate cancer using 3D-modeling from hip DXA","authors":"Ji Yong Park ,&nbsp;A Ram Hong ,&nbsp;Jee Hee Yoon ,&nbsp;Hee Kyung Kim ,&nbsp;Ho-Cheol Kang ,&nbsp;Seung Il Jung ,&nbsp;Dongdeuk Kwon ,&nbsp;Eu Chang Hwang","doi":"10.1016/j.jbo.2025.100713","DOIUrl":"10.1016/j.jbo.2025.100713","url":null,"abstract":"<div><h3>Introduction</h3><div>Androgen deprivation therapy (ADT) for prostate cancer negatively affect areal bone mineral density (aBMD); however, its impact on volumetric BMD (vBMD) and bone geometry remains underexplored. This study aimed to evaluate changes in aBMD, vBMD, and hip structural analysis (HSA) following one year of ADT.</div></div><div><h3>Materials and methods</h3><div>This retrospective observational study included 41 patients with prostate cancer without bone metastasis who received ADT for one year and underwent dual-energy X-ray absorptiometry (DXA) both before and after treatment. In addition to aBMD, trabecular and cortical vBMD, integral vBMD (trabecular + cortical), cortical surface BMD (sBMD), cortical thickness, and hip structural parameters were assessed at the hip using 3D-Shaper software.</div></div><div><h3>Results</h3><div>The mean age and body mass index of the patients were 75.5 ± 6.8 years and 24.0 ± 3.0 kg/m², respectively. More than half had a Gleason score of 4 or 5, and the majority had T3 disease. After one year of ADT, significant reductions in aBMD were observed at the lumbar spine (–4.5 ± 4.0 %, <em>P</em> &lt; 0.001) and total hip (–3.7 ± 5.1 %, <em>P</em> &lt; 0.001). 3D-DXA analysis revealed significant declines in integral vBMD (–3.8 ± 3.9 %) and trabecular vBMD (–4.9 ± 7.4 %) (both <em>P</em> &lt; 0.001), while cortical vBMD showed no significant change (–1.6 ± 6.0 %, <em>P</em> = 0.062) at the total hip. Cortical sBMD decreased significantly by –2.7 ± 5.2 % (<em>P</em> &lt; 0.001). Cortical thickness also significantly decreased at the total hip (–1.2 ± 3.2 %, <em>P</em> = 0.011). With respect to hip structural parameters, cross-sectional area consistently decreased, and buckling ratio increased across the femoral neck, trochanteric, and shaft regions (all <em>P</em> &lt; 0.05), indicating increased femoral fragility and reduced resistance to axial and compressive forces.</div></div><div><h3>Conclusions</h3><div>ADT exerts a substantial detrimental effect on bone strength, resulting in reductions in aBMD, vBMD, and alteration of HSA. 3D-DXA may serve as a valuable and accessible tool for detecting structural bone changes in prostate cancer patients undergoing ADT.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"55 ","pages":"Article 100713"},"PeriodicalIF":3.5,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osseous invasion in extremity soft-tissue sarcomas: prevalence, diagnosis, and surgical management- A narrative review","authors":"Seyyed Saeed Khabiri ,&nbsp;Khalil Kargar Shooroki ,&nbsp;Sadegh Saberi ,&nbsp;Hamed Naghizadeh","doi":"10.1016/j.jbo.2025.100712","DOIUrl":"10.1016/j.jbo.2025.100712","url":null,"abstract":"<div><h3>Background</h3><div>Osseous invasion in extremity soft-tissue sarcomas (STS) occurs in approximately 5–11% of cases and is associated with larger tumor size, higher histologic grade, deeper location, and increased risk of metastasis. Despite its relative rarity, bone invasion is a critical prognostic factor, presenting unique diagnostic and surgical challenges.</div></div><div><h3>Purpose</h3><div>This review aimed to synthesize current evidence on the prevalence, diagnostic imaging, surgical management, and prognostic impact of osseous invasion in extremity STS and to offer evidence-based recommendations for clinical practice.</div></div><div><h3>Methods</h3><div>A comprehensive narrative review was conducted using structured searches of PubMed, Embase, and Cochrane Library, focusing on studies reporting original data on extremity STS with bone involvement. The key outcomes included diagnostic accuracy, surgical margins, functional recovery, and survival rates.</div></div><div><h3>Results</h3><div>Bone invasion significantly predicted poorer overall and disease-free survival, with 5-year survival rates of 27–40% compared to 60–70% in non-invasive cases. MRI remains the imaging modality of choice, although standardized radiological criteria for bone invasion are lacking. En-bloc resection provides reliable local control but carries substantial morbidity. Emerging bone-sparing techniques, such as subperiosteal and hemicortical resections, have demonstrated comparable oncologic outcomes with superior functional results in selected patients.</div></div><div><h3>Conclusions</h3><div>Bone invasion in extremity STS represents a high-risk tumor subset that warrants individualized multidisciplinary management. While wide resection remains the standard treatment in cases with medullary involvement, selected patients may benefit from function-preserving approaches without compromising oncologic safety. Future research should focus on standardizing the diagnostic criteria, validating conservative surgical strategies, and refining multimodal treatment protocols to optimize outcomes.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"54 ","pages":"Article 100712"},"PeriodicalIF":3.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic body radiotherapy for spine and non-spine bone metastases in prostate carcinoma – a multicenter cohort analysis","authors":"Franziska Nägler ,&nbsp;Isabell Seiler ,&nbsp;Sebastian Schäfer ,&nbsp;Johannes Meents ,&nbsp;Fabian Lohaus ,&nbsp;Arne Grün ,&nbsp;Olaf Wittenstein ,&nbsp;Kenneth Klischies ,&nbsp;Julia Remmele ,&nbsp;Alexander Rühle ,&nbsp;Miriam Eckl ,&nbsp;Oliver Blanck ,&nbsp;Judit Boda-Heggemann ,&nbsp;Frank A. Giordano ,&nbsp;Christos Moustakis ,&nbsp;Nils H. Nicolay ,&nbsp;Lena Kästner","doi":"10.1016/j.jbo.2025.100710","DOIUrl":"10.1016/j.jbo.2025.100710","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Metastases-directed radiotherapy plays an increasing role in oligometastatic prostate cancers (OMPC). Here, we investigated the role of stereotactic body radiotherapy (SBRT) for spine and non-spine bone metastases (BoM) from prostate cancer in a large real-world multicenter cohort.</div></div><div><h3>Material and methods</h3><div>This multicenter cohort analysis from five tertiary cancer centers included patient data of spine and non-spine BoM irradiated between 2010 and 2024. Overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), SBRT target volumes and doses, toxicity, and the role of additional systemic therapies were evaluated retrospectively.</div></div><div><h3>Results</h3><div>231 patients (341 BoM) with median follow-up time of 28.3 months were included. Most common localization were spine (39.3 %), pelvic bone (31.7 %), and ribs (17.9 %). 1- and 5-year PFS for spine BoM were 93.8 % (95 %CI:84.2–97.6 %) and 32.1 % (95 %CI:16.8–44.4 %) and for non-spine BoM 91.7 % (95 %CI:85.1–95.5 %) and 36.6 % (95 %CI:25.8–47.5 %), respectively. 1- and 5-year OS for spine BoM amounted to 94.2 % (95 %CI:85.3–97.8 %) and 69.2 % (95 %CI:50.2–82.2 %) and for non-spine 100 % and 73.3 % (95 %CI:59.1–83.3 %). Older age (p &lt; 0.005) and additional systemic therapies (p = 0.05) were associated with worse OS, older age and larger treatment volumes with worse PFS (p = 0.04). Toxicities were low, with fracture rates of 0.3 % (acute) and 1.2 % (late).</div></div><div><h3>Conclusion</h3><div>Bone SBRT for OMPC is an effective treatment with low toxicity and particularly low fracture rates for both spine and non-spine BoM with no difference in outcome based on the localization. Prospective trials will help to identify the patients benefitting most from this approach and to establish standardized SBRT concepts incorporating systemic treatments.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"54 ","pages":"Article 100710"},"PeriodicalIF":3.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic bone disease in proximal femur. Outcome of surgical treatments. − Do we know what to do?","authors":"K. Kilk ,&nbsp;G. Kask ,&nbsp;J. Nieminen ,&nbsp;M.K. Laitinen","doi":"10.1016/j.jbo.2025.100711","DOIUrl":"10.1016/j.jbo.2025.100711","url":null,"abstract":"<div><h3>Background</h3><div>Skeletal metastases related pathological fracture reconstruction methods in proximal femur range from osteosynthesis to tumor prostheses with acetabular reconstruction, depending on lesion size and location. This retrospective study, of 299 patients surgically treated for proximal femur metastases, investigates implant survival, complications, and functional outcomes of various surgical strategies for treating pathological fractures of the proximal femur.</div></div><div><h3>Patients and methods</h3><div>This retrospective study of 299 patients surgically treated for proximal femur metastases, investigates implant survival (Kaplan–Meier), complications, and functional outcomes of different surgical strategies. The chi-test and Mann-Witney <em>U</em> test were used for analysis between groups. The subdistribution Hazard Ratio (SHR) of the role of factors affecting implant survival was calculated using competing risk analysis.</div></div><div><h3>Results</h3><div>Reconstruction methods comprised osteosynthesis (n = 59), hemiarthroplasty (n = 72), total hip replacement (THA) (n = 43), and endoprosthetic replacement (EPR) either with or without acetabular component (n = 125). The precise location and size of the metastases was evaluated. The mean implant survival was 17 months (SD 21.2). Complications occurred in 33 patients, 20 required revision surgery. In prosthesis patients, infections and dislocations were the main complications, while mechanical failure predominated in the osteosynthesis group. Mean implant failure time was 11 months, shortest in THA and osteosynthesis. Functional outcomes in 38 patients showed a mean Oxford Hip Score (OHS) of 33, with no significant differences across methods.</div></div><div><h3>Interpretation</h3><div>Patient survival is a critical factor in selecting the appropriate reconstruction method for trochanteric metastatic lesions. Osteosynthesis is suitable for patients with a limited life expectancy. In cases of metastases involving the head-neck anatomical region, arthroplasty with acetabular reconstruction offers no advantage over hemiarthroplasty. With our data there was no statistical difference in functional outcome between different surgical methods.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"54 ","pages":"Article 100711"},"PeriodicalIF":3.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified OPTIModel with oligometastatic disease for the prediction of overall survival of patients with renal cell cancer and symptomatic long bone metastases","authors":"E.W. Dootjes ,&nbsp;J.J. Willeumier ,&nbsp;C.W.P.G. van der Wal ,&nbsp;R.J.P. van der Wal ,&nbsp;P. van der Zwaal ,&nbsp;A. Leithner ,&nbsp;A.A.M. van der Veldt ,&nbsp;M. Fiocco ,&nbsp;D.L.M. van Broekhoven ,&nbsp;Y.M. van der Linden","doi":"10.1016/j.jbo.2025.100709","DOIUrl":"10.1016/j.jbo.2025.100709","url":null,"abstract":"<div><h3>Aims</h3><div>For patients with long bone metastasis (LBM), we have previously developed OPTIModel. In this study, we investigated whether the OPTIModel could be improved for patients with metastatic renal cell cancer (mRCC) by including oligometastatic bone metastases (OBM) as a risk factor.</div></div><div><h3>Methods</h3><div>Patients with mRCC and symptomatic LBMs were included in a retrospective and prospective multicenter cohort. Bone metastases (BMs) were categorized as: solitary (SBM), limited BMs (2–4 BMs) or diffuse BMs (DBM; &gt;4 BMs). OBM were defined as ≤ 4 BMs. Overall survival was estimated using Kaplan Meier method. Effect of risk factors on overall survival were assessed using multivariate Cox regression model. Based on these results, the OPTIModel was modified. To assess the discriminatory ability, Harrell’s C-statistic was used.</div></div><div><h3>Results</h3><div>178 patients were included. Overall, median overall survival was 12.1 months (95 % confidence interval (CI): 8.8–15.3). Median survival for SBM (n = 53, 29.8 %), limited BMs (n = 60, 33.7 %) and DBMs (n = 65, 36.5 %) was 19.6 months (95 %CI: 6.8–32.4), 14.8 months (95 %CI: 7.6–21.9) and 6.1 months (95 %CI: 2.7–9.5), respectively. Median survival was 16.3 months (95 %CI: 10.6–22.0) in patients with OBM (n = 113, 63.5 %), with a hazard ratio of 2.11 (95 %CI: 1.44–3.09) compared to patients with DBM. Including OBM in the OPTIModel for mRCC improved C-statistic from 0.585 (standard error (SE) = 0.027) to 0.618 (SE = 0.024).</div></div><div><h3>Conclusion</h3><div>Both SBM and limited BMs were associated with a longer overall survival in patients with mRCC and symptomatic LBMs. The modified OPTIModel for mRCC with inclusion of oligometastatic disease could guide decisions about local treatment of symptomatic LBMs.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"55 ","pages":"Article 100709"},"PeriodicalIF":3.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}