We previously developed genitourinary (GU) cancer-specific scoring system for prediction of survival in patients with bone metastasis (the Bone-Fujimoto-Owari-Miyake [B-FOM] scoring model) based on five prognostic factors: the type of primary tumor (prostate cancer (PCa) vs renal cell carcinoma (RCC) and PCa vs urothelial carcinoma (UC)), poor performance status (PS), visceral metastasis, high Glasgow-prognostic score (GPS), elevated neutrophil-to-lymphocyte ratio (NLR). The aim of this study was to externally validate and further improve the performance of the B-FOM score.
The external validation cohort comprised 309 patients with GU cancer with bone metastasis from multiple institutions. Clinical factors were analyzed using Kaplan-Meier method and COX regression hazard model. Performance of a modified B-FOM score was compared to that of other scoring models by the Kaplan-Meier method and the area under the curve (AUC) of receiver operating characteristic curves.
The median follow-up period of development and validation cohort were 25 and 17 months, respectively. Kaplan-Meier curve demonstrated that the type of primary tumor (RCC and UC vs PCa), poor PS, presence of visceral metastasis, high GPS, elevated NLR were significantly associated with shorter cancer-specific survival. Risk groups were successfully stratified by the modified B-FOM score classification. Moreover, the AUC of the modified B-FOM scoring model for predicting mortality at 6, 12, and 24 months were 0.895, 0.856, and 0.815, respectively, which were the highest among evaluated models.
The B-FOM scoring model is a simple and accurate prediction tool. By using this scoring model at the time of the diagnosis of bone metastasis in patients with GU cancers, an individualized optimal treatment strategy can be selected.
Journal of bone oncology. 2020 Dec 13*** epublish ***
Takuya Owari, Makito Miyake, Yasushi Nakai, Nobumichi Tanaka, Yoshitaka Itami, Shuya Hirao, Hitoshi Momose, Yoshinori Nakagawa, Kouta Iida, Fumisato Maesaka, Takuto Shimizu, Yusuke Iemura, Yoshihiro Matsumoto, Masaomi Kuwada, Takeshi Otani, Kenji Otsuka, Eijiro Okajima, Yukinari Hosokawa, Ryosuke Okamura, Kiyohide Fujimoto
Department of Urology, Nara Medical University, Kashihara, Nara, Japan., Hirao Hospital, Kashihara, Nara, Japan., Yamatotakada Municipal Hospital, Yamatotakada, Nara, Japan., Nara Prefecture General Medical Center, Nara, Nara, Japan., Hoshigaoka Medical Center, Hirakata, Osaka, Japan., Matsuzaka General Hospital, Matsuzaka, Mie, Japan., Okanami General Hospital, Iga, Mie, Japan., Nara City Hospital, Nara, Nara, Japan., Tane General Hospital, Osaka, Osaka, Japan., Kyoto University, Kyoto, Kyoto, Japan.