改良的OPTIModel伴少转移性疾病预测肾细胞癌伴症状性长骨转移患者总生存期

IF 3.5 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2025-09-02 DOI:10.1016/j.jbo.2025.100709

E.W. Dootjes , J.J. Willeumier , C.W.P.G. van der Wal , R.J.P. van der Wal , P. van der Zwaal , A. Leithner , A.A.M. van der Veldt , M. Fiocco , D.L.M. van Broekhoven , Y.M. van der Linden

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引用次数: 0

摘要

针对长骨转移（LBM）患者，我们已经建立了OPTIModel。在这项研究中，我们研究了将低转移性骨转移（OBM）作为一个危险因素是否可以改善转移性肾细胞癌（mRCC）患者的OPTIModel。方法将mRCC和症状性lbm患者纳入回顾性和前瞻性多中心队列。骨转移（BMs）分为：孤立性（SBM）、局限性转移（2-4个BMs）或弥漫性转移（DBM; >；4个BMs）。OBM定义为≤4个BMs。用Kaplan Meier法估计总生存期。采用多因素Cox回归模型评估危险因素对总生存率的影响。基于这些结果，对OPTIModel进行了修正。采用Harrell’s c统计量来评估区分能力。结果共纳入178例患者。总体而言，中位总生存期为12.1个月（95%置信区间（CI）： 8.8-15.3）。SBM （n = 53, 29.8%）、有限bm （n = 60, 33.7%）和DBMs （n = 65, 36.5%）的中位生存期分别为19.6个月（95% CI: 6.8-32.4）、14.8个月（95% CI: 7.6-21.9）和6.1个月（95% CI: 2.7-9.5）。OBM患者（n = 113, 63.5%）的中位生存期为16.3个月（95% CI: 10.6-22.0），与DBM患者相比，风险比为2.11 （95% CI: 1.44-3.09）。在mRCC的OPTIModel中加入OBM将c -统计量从0.585（标准误差(SE) = 0.027）提高到0.618 （SE = 0.024）。结论在mRCC和有症状的lbm患者中，SBM和有限bm都与更长的总生存期相关。包含少转移性疾病的mRCC的改进OPTIModel可以指导有症状lbm的局部治疗决策。

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Modified OPTIModel with oligometastatic disease for the prediction of overall survival of patients with renal cell cancer and symptomatic long bone metastases

Aims

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.

Methods

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; >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.

Results

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).

Conclusion

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.

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.