Biological behavior and clinical management of bone metastases of carcinomas

Objectives: Worldwide, carcinomas are a major cause of death; bone metastases cause increased mortality and morbidity. There are many treatment methods for bone metastases. The expected survival time is the most important factor determining treatment method. There are previously developed prognostic models. In this study, we aimed to evaluate the factors affecting the survival of patients with bone metastases and the clinical applicability of prognostic models. Materials and methods: We retrospectively evaluated 247 patients who applied to our hospital between 2011 and 2021 with the diagnosis of bone carcinoma metastasis. Demographic data, general health status, primary diagnoses, laboratory and imaging findings, pathological fracture status, treatment methods and survival times of the patients were recorded and it was evaluated effects of these variables on survival time. Previously developed Katagiri, Janssen, Spring, PathFX and SORG prognostic models were applied and the predictive performances of these models were evaluated by comparing the predicted survival time with the actual survival time of our patients. Results: After the multivariate analysis, various laboratory values, body mass indexes, patient performance status, primary diagnoses, extraspinal and extraskeletal metastases or pathological fractures were shown to be significantly associated with the survival time of patients. Although all prognostic models are clinically applicable, their performances vary. Conclusion: The significant prognostic factors were generally in line with the literature. Prognostic models were evaluated at related months and performance data were provided. We think that our results will provide insight in the selection of these prognostic models when deciding on the treatment method.