ArticleAmerican journal of cancer research2026
Survival outcomes in patients with metachronous breast cancer bone metastasis: an 11-year single-institution retrospective study.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study aimed to analyze the clinical characteristics of metachronous breast cancer bone metastasis (BCBM) and construct a graded prognostic assessment (GPA) model. A retrospective analysis was conducted on the clinical data of newly diagnosed breast cancer patients with bone metastasis (BM). Data collected included initial involvement of bone substructures and metastatic burden other than BM. Receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis (DCA) were used to evaluate the efficacy of the Cox regression model, and a GPA model for overall survival (bmOS) after BM was constructed. The DeLong test was used to compare the area under the curve (AUC) of the training and validation sets to validate the model efficacy. A total of 2103 BMs were detected in 308 patients with metachronous BCBM. The most common sites were the thoracic spine (24.8%), lumbar spine (16.7%), ribs (11.9%), and iliac bone (10.2%); 80.1% of the lesions were osteolytic. Independent prognostic risk factors for bmOS included in the GPA model included initial stage, molecular subtype, time to BM (TTBM), BM numbers, and extraosseous visceral metastases (EVM). The model showed no statistically significant difference in AUC between the training and validation sets (DeLong test, P > 0.05). Patients were divided into three risk strata based on GPA scores (0-8.5), with significant differences in median survival: 60.3, 40.0, and 32.6 months in the training set (P < 0.001), and 64.0, 41.6, and 25.3 months in the validation set (P < 0.001). Initial treatment failure was predominantly due to bone progression (39.3%) and visceral progression (28.2%). In conclusion, the prognosis of patients with metachronous BCBM exhibits significant heterogeneity. The GPA model developed in this study can serve as a practical prognostic assessment tool and provide a reference for individualized treatment planning.
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