Modeling survival prognosis in female patients with bone metastases from lung adenocarcinoma: A retrospective study based on the SEER database and a Chinese cohort

The objective of this investigation was to quantify the survival advantages by utilizing multi-center population-based data for delineating risk factors in female patients afflicted with lung adenocarcinoma (LUAD) bone metastases. Investigators analyzed surveillance, epidemiology, and end results data of 5534 female LUAD patients with bone metastases from 2010 to 2015, and subsequently split this cohort into a training set, an internal validation set, and an external cohort comprising a total of 114 patients. Independent risk factors screened by univariate and multivariate Cox analyses were used to create nomograms for overall survival in the training cohort, and the performance of the nomograms was assessed by calibration curves, receiver operating characteristic curves, and decision curve analysis curves. Kaplan–Meier analyses were conducted to evaluate survival disparities based on patient risk stratification. Multivariate analysis unveiled that race, age, T stage, N stage, surgery, radiotherapy, chemotherapy, brain metastases, and liver metastases were independent prognostic factors. In the training set, the area under the curve values for 1-, 2-, and 3-year survival were 0.745, 0.728, and 0.727, respectively. The C-index attained values of 0.693, 0.681, and 0.744 across the 3 cohorts. Decision curve analysis indicates model may better inform clinical practice and decision-making than TNM staging. As evidenced by the Kaplan–Meier survival curve, the high-risk cohort exhibited a marked and statistically significant reduction in survival rate compared to the low-risk cohort. We proficiently identified independent prognostic factors for overall survival among female LUAD patients. Furthermore, we formulated an innovative prognostic model capable of predicting 1-, 2-, and 3-year survival in this cohort.