ArticleCancer medicine2023
Comparison of eight modern preoperative scoring systems for survival prediction in patients with extremity metastasis.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 10 citations in OpenAlex.
- Post-operative survival and use of systemic therapy in metastatic long-bone disease: 12 years of institutional experience.Journal of bone oncology · 2026Article
- Article
- Differential survival outcomes in upper versus lower extremity metastatic bone disease: a retrospective comparative cohort analysis.Journal of orthopaedic surgery and research · 2025Article
- CORR Insights®: What Factors Are Associated With Implant Revision in the Treatment of Pathologic Subtrochanteric Femur Fractures?Clinical orthopaedics and related research · 2025Article
- Are Current Survival Prediction Tools Useful When Treating Subsequent Skeletal-related Events From Bone Metastases?Clinical orthopaedics and related research · 2024Article
- Comparison of eight modern preoperative scoring systems for survival prediction in patients with extremity metastasis.Cancer medicine · 2023Article
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Authors and funding
17 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurvival is an important factor to consider when clinicians make treatment decisions for patients with skeletal metastasis. Several preoperative scoring systems (PSSs) have been developed to aid in survival prediction. Although we previously validated the Skeletal Oncology Research Group Machine-learning Algorithm (SORG-MLA) in Taiwanese patients of Han Chinese descent, the performance of other existing PSSs remains largely unknown outside their respective development cohorts. We aim to determine which PSS performs best in this unique population and provide a direct comparison between these models.
methodsWe retrospectively included 356 patients undergoing surgical treatment for extremity metastasis at a tertiary center in Taiwan to validate and compare eight PSSs. Discrimination (c-index), decision curve (DCA), calibration (ratio of observed:expected survivors), and overall performance (Brier score) analyses were conducted to evaluate these models' performance in our cohort.
resultsThe discriminatory ability of all PSSs declined in our Taiwanese cohort compared with their Western validations. SORG-MLA is the only PSS that still demonstrated excellent discrimination (c-indexes>0.8) in our patients. SORG-MLA also brought the most net benefit across a wide range of risk probabilities on DCA with its 3-month and 12-month survival predictions.
conclusionsClinicians should consider potential ethnogeographic variations of a PSS's performance when applying it onto their specific patient populations. Further international validation studies are needed to ensure that existing PSSs are generalizable and can be integrated into the shared treatment decision-making process. As cancer treatment keeps advancing, researchers developing a new prediction model or refining an existing one could potentially improve their algorithm's performance by using data gathered from more recent patients that are reflective of the current state of cancer care.
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