Diagnostic and prognostic factors, and two nomograms for endometrial cancer patients with bone metastasis

Abstract

Patients with endometrial cancer (EC) who develop bone metastasis (BM) always imply a poorer prognosis. However, reliable predictive models associated with BM from EC are currently limited. We retrospectively analyzed data on 54,077 patients diagnosed with primary EC in the Surveillance, Epidemiology, and End Results database. Multivariate logistic regression analysis was used to determine independent predictors of BM from EC. Univariate and multivariate Cox regression analyses were used to determine independent prognostic factors for EC with BM. Based on independent predictors and prognostic factors, we constructed a diagnostic nomogram and prognostic nomogram separately. Besides, calibration curves, receiver operating characteristic curves, and decision curve analysis were used to evaluate the models. A total of 54,077 patients with EC from the Surveillance, Epidemiology, and End Results database were included in this study, 364 of whom had BM. Multivariate analysis in the logistic model showed that lung metastasis, liver metastasis, brain metastasis, N stage, T stage, histologic grade, and race were risk factors for BM from EC. Multivariate analysis in the Cox model showed that liver metastasis, brain metastasis, chemotherapy, surgery, and histologic type had a significant effect on overall survival. Moreover, the receiver operating characteristic curve, calibration curve, and decision curve analysis indicated the good performance of both diagnostic and prognostic nomograms. Two clinical prediction model was constructed and validated to predict individual risk and overall survival for EC with BM, respectively. Diagnostic nomogram and prognostic nomogram are complementary, improving the clinician's ability to assess the patient's prognosis and enhancing prognosis-based decision making.

Incidence, risk factors, and a prognostic nomogram for distant metastasis in endometrial cancer: A SEER‐based study

“…Advanced EC with distant metastasis is a relatively rare disease, with a 5‐year OS rate of less than 10% 5,14 . There are few studies on distant metastasis in EC patients, and most of them tended to focus on single‐site metastasis or distant organ metastasis, with rare emphasis on the role of multiple distant metastases or rare site metastasis in EC 15,16 . To gain a more comprehensive understanding of the relationship between incidence, clinicopathologic features, and survival outcomes, we conducted this study to analyze the epidemiology trend and established a nomogram to accurately predict the prognosis of EC patients with distant metastasis.…”