Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation Cohort

ABSTRACT Background Lung adenocarcinoma is a common type of cancer that can lead to bone metastasis and has a poor prognosis. Although previous studies have established nomograms for lung adenocarcinoma, these nomograms do not effectively predict the prognosis of lung adenocarcinoma patients with bo...

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Main Authors: Zhiming Liu, Min Zhang, Shuo Han, Hao Zhang, Shengwei Meng, Zhubin Shen, Xuexiao Ma
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Cancer Reports
Subjects:
Online Access:https://doi.org/10.1002/cnr2.70211
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author Zhiming Liu
Min Zhang
Shuo Han
Hao Zhang
Shengwei Meng
Zhubin Shen
Xuexiao Ma
author_facet Zhiming Liu
Min Zhang
Shuo Han
Hao Zhang
Shengwei Meng
Zhubin Shen
Xuexiao Ma
author_sort Zhiming Liu
collection DOAJ
description ABSTRACT Background Lung adenocarcinoma is a common type of cancer that can lead to bone metastasis and has a poor prognosis. Although previous studies have established nomograms for lung adenocarcinoma, these nomograms do not effectively predict the prognosis of lung adenocarcinoma patients with bone metastasis. This study aims to establish and validate a new nomogram to solve this problem. Methods Data were collected from the SEER database and from patients at our hospital who had been diagnosed with lung adenocarcinoma and developed bone metastases. The patients were randomly assigned into the training and internal validation sets in a 7:3 ratio. External validation was conducted using an independent patient cohort from two hospitals. Different methods were used to evaluate the nomogram's performance. The relationship between different metastatic sites and radiotherapy and chemotherapy was also analyzed to evaluate patient prognosis. Results The following factors were identified as significant prognostic indicators: age, sex, marital status, T stage, N stage, tumor grade, tumor size, presence of brain and liver metastases, and receipt of chemotherapy. The nomogram's concordance indices for predicting overall survival were consistently above 0.7, and the area under the curve values, calibration plots, and decision curves all confirmed the nomogram's strong predictive accuracy. Moreover, our analysis revealed that chemotherapy was the most effective treatment modality. Conclusions This study developed a nomogram that can predict the prognosis of lung adenocarcinoma patients with bone metastasis. The results showed that patients with liver metastasis had the worst prognosis and that chemotherapy was the most effective treatment regimen for patients with different metastatic sites.
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spelling doaj-art-933e9def4893451b820e8a59cc3f3fec2025-08-20T02:30:23ZengWileyCancer Reports2573-83482025-05-0185n/an/a10.1002/cnr2.70211Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation CohortZhiming Liu0Min Zhang1Shuo Han2Hao Zhang3Shengwei Meng4Zhubin Shen5Xuexiao Ma6Department of Spine Surgery The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Neonatology The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Spine Surgery The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Spine Surgery The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Spine Surgery The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Spine Surgery China‐Japan Union Hospital of Jilin University Changchun ChinaDepartment of Spine Surgery The Affiliated Hospital of Qingdao University Qingdao ChinaABSTRACT Background Lung adenocarcinoma is a common type of cancer that can lead to bone metastasis and has a poor prognosis. Although previous studies have established nomograms for lung adenocarcinoma, these nomograms do not effectively predict the prognosis of lung adenocarcinoma patients with bone metastasis. This study aims to establish and validate a new nomogram to solve this problem. Methods Data were collected from the SEER database and from patients at our hospital who had been diagnosed with lung adenocarcinoma and developed bone metastases. The patients were randomly assigned into the training and internal validation sets in a 7:3 ratio. External validation was conducted using an independent patient cohort from two hospitals. Different methods were used to evaluate the nomogram's performance. The relationship between different metastatic sites and radiotherapy and chemotherapy was also analyzed to evaluate patient prognosis. Results The following factors were identified as significant prognostic indicators: age, sex, marital status, T stage, N stage, tumor grade, tumor size, presence of brain and liver metastases, and receipt of chemotherapy. The nomogram's concordance indices for predicting overall survival were consistently above 0.7, and the area under the curve values, calibration plots, and decision curves all confirmed the nomogram's strong predictive accuracy. Moreover, our analysis revealed that chemotherapy was the most effective treatment modality. Conclusions This study developed a nomogram that can predict the prognosis of lung adenocarcinoma patients with bone metastasis. The results showed that patients with liver metastasis had the worst prognosis and that chemotherapy was the most effective treatment regimen for patients with different metastatic sites.https://doi.org/10.1002/cnr2.70211bone metastasischemotherapylung adenocarcinomaoverall survivalradiotherapysurvival nomogram
spellingShingle Zhiming Liu
Min Zhang
Shuo Han
Hao Zhang
Shengwei Meng
Zhubin Shen
Xuexiao Ma
Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation Cohort
Cancer Reports
bone metastasis
chemotherapy
lung adenocarcinoma
overall survival
radiotherapy
survival nomogram
title Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation Cohort
title_full Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation Cohort
title_fullStr Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation Cohort
title_full_unstemmed Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation Cohort
title_short Survival Nomogram for Lung Adenocarcinoma Patients With Bone Metastasis Based on the SEER Database and an External Validation Cohort
title_sort survival nomogram for lung adenocarcinoma patients with bone metastasis based on the seer database and an external validation cohort
topic bone metastasis
chemotherapy
lung adenocarcinoma
overall survival
radiotherapy
survival nomogram
url https://doi.org/10.1002/cnr2.70211
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