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. 2021 Oct;49(10):3000605211050735.
doi: 10.1177/03000605211050735.

Diagnostic and prognostic nomograms for bone metastasis in small cell lung cancer

Chenan Liu  1   2 , Jiahong Yi  1 , Junmei Jia  2
Affiliations

Diagnostic and prognostic nomograms for bone metastasis in small cell lung cancer

Chenan Liu et al. J Int Med Res. 2021 Oct.

Abstract

Objective: Patients with bone metastasis (BM) of small cell lung cancer (SCLC) have a poor prognosis. We aimed to identify predictors and prognostic factors in patients with BM of SCLC and construct nomograms to predict BM.

Methods: We retrospectively analyzed 18,187 cases from the Surveillance, Epidemiology, and End Results database reported between 2010 and 2016. Differences in overall survival (OS) and cancer-specific survival (CSS) were evaluated after propensity score matching. Independent predictors for BM and prognostic factors for patients with BM of SCLC were determined using univariate and multivariate regression analyses. Two nomograms were constructed and evaluated using C-statistics.

Results: BM was observed in 4014 (22.07%) patients. Kaplan-Meier survival analysis revealed significant differences between BM and non-BM groups. The median OS for patients with and without BM was 6 and 7 months, respectively. The median CSS for patients with and without BM was 9 and 13 months, respectively. Age, sex, tumor size, N stage, chemotherapy, surgery, radiotherapy, and liver/brain/lung metastases were related to BM and independent prognostic factors for OS and CSS. Diagnostic and prognostic nomograms were generated.

Conclusion: Our nomograms predicted the incidence of BM and the 5-month survival rate of patients with SCLC and BM.

Keywords: Epidemiology; Small cell lung cancer; Surveillance; and End Results database; bone metastasis; nomogram; predictor; prognosis.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Kaplan–Meier curves of overall survival (a) and cancer-specific survival (b) for patients stratified by the presence (N = 4014) or absence (N = 14,173) of BM. BM, bone metastasis.
Figure 2.
Figure 2.
Multivariable logistic regression analyses of factors associated with BM. BM, bone metastasis; AK, Alaska; CI, confidence interval.
Figure 3.
Figure 3.
A nomogram for predicting the risk of BM in patients with SCLC. Other includes American Indians/Alaska Natives and Asian/Pacific Islanders. The size of the cyan square and grey area under the curve on the total points axis represents the sample size. The population distribution of patients with SCLC are shown. BM, bone metastasis; SCLC, small cell lung cancer.
Figure 4.
Figure 4.
A nomogram for predicting the prognosis of patients with BM of SCLC. Other includes American Indians/Alaska Natives and Asian/Pacific Islanders. The size of the cyan square and grey area under the curve on the total points axis represents the sample size. The population distribution of patients with SCLC are shown. BM, bone metastasis; SCLC, small cell lung cancer.
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