ArticleBMC cancer2015
How do we estimate survival? External validation of a tool for survival estimation in patients with metastatic bone disease-decision analysis and comparison of three international patient populations.
Article in BMC cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Availability and reporting quality of external validations of machine-learning prediction models with orthopedic surgical outcomes: a systematic review.Acta orthopaedica · 2021Pooled it
- Fractures in bone tumour prosthesis.International orthopaedics · 2015Pooled it
- The use of hook acetabular cage after intralesional surgery in secondary bone tumors of the acetabulum: indications and results at medium term.Musculoskeletal surgery · 2026Article
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- Validation of nine prognostic models in patients with bone metastases undergoing surgery.Journal of orthopaedic surgery and research · 2025Article
- Differential survival outcomes in upper versus lower extremity metastatic bone disease: a retrospective comparative cohort analysis.Journal of orthopaedic surgery and research · 2025Article
- Artificial Intelligence in bone Metastases: A systematic review in guideline adherence of 92 studies.Journal of bone oncology · 2025Review
- Modern Treatment of Skeletal Metastases: Multidisciplinarity and the Concept of Oligometastasis in the Recent Literature.Current oncology (Toronto, Ont.) · 2025Review
- Carbon vs. Titanium Nails in the Treatment of Impending and Pathological Fractures: A Literature Review.Journal of clinical medicine · 2024Review
- Preoperative Albumin and Postoperative CRP/Albumin Ratio (CARS) are Independent Predictive Factors in Estimating 1-Year Mortality in Patients Operated for Proximal Femoral Metastasis with Endoprosthesis.Indian journal of orthopaedics · 2024Article
- Comparison of eight modern preoperative scoring systems for survival prediction in patients with extremity metastasis.Cancer medicine · 2023Article
- Intramedullary nailing vs modular megaprosthesis in extracapsular metastases of proximal femur: clinical outcomes and complication in a retrospective study.BMC musculoskeletal disorders · 2022Article
- Can a Bayesian belief network for survival prediction in patients with extremity metastases (PATHFx) be externally validated in an Asian cohort of 356 surgically treated patients?Acta orthopaedica · 2022Article
- Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study.BMC musculoskeletal disorders · 2022Article
- Article
- The Prediction of Survival after Surgical Management of Bone Metastases of the Extremities-A Comparison of Prognostic Models.Current oncology (Toronto, Ont.) · 2022Review
- Quantitative preoperative patient assessments are related to survival and procedure outcome for osseous metastases.Journal of bone oncology · 2022Article
- Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis.Current oncology (Toronto, Ont.) · 2022Article
- Prognosis by cancer type and incidence of zoledronic acid-related osteonecrosis of the jaw: a single-center retrospective study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Harrington rods for periacetabular pathological lesion: is it an option?Irish journal of medical science · 2022Review
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21 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWe recently developed a clinical decision support tool, capable of estimating the likelihood of survival at 3 and 12 months following surgery for patients with operable skeletal metastases. After making it publicly available on www.PATHFx.org , we attempted to externally validate it using independent, international data.
methodsWe collected data from patients treated at 13 Italian orthopaedic oncology referral centers between 2010 and 2013, then applied to PATHFx, which generated a probability of survival at three and 12-months for each patient. We assessed accuracy using the area under the receiver-operating characteristic curve (AUC), clinical utility using Decision Curve Analysis (DCA), and compared the Italian patient data to the training set (United States) and first external validation set (Scandinavia).
resultsThe Italian dataset contained 287 records with at least 12 months follow-up information. The AUCs for the three-month and 12-month estimates was 0.80 and 0.77, respectively. There were missing data, including the surgeon's estimate of survival that was missing in the majority of records. Physiologically, Italian patients were similar to patients in the training and first validation sets. However notable differences were observed in the proportion of those surviving three and 12-months, suggesting differences in referral patterns and perhaps indications for surgery.
conclusionsPATHFx was successfully validated in an Italian dataset containing missing data. This study demonstrates its broad applicability to European patients, even in centers with differing treatment philosophies from those previously studied.
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