Discussion
esophageal cancer, malignancies, cancer
METASTASIS, OESOPHAGEAL CANCER, INFLAMMATION, CANCER, BONE METASTASIS, MALIGNANT TUMORS, MALIGNANCIES, NASOPHARYNGEAL CARCINOMA, INFLAMMATION, REGRESSION, METASTASES
Although great progress has been made in the diagnosis and treatment of BC, the occurrence of bone metastasis still brings great challenges to the clinicians. Advanced BC is regarded as incurable with current therapeutic strategy [Among our study, the prognosis of patients with additional organ metastatic sites was usually poorer than that of patients with bone-only metastasis. Consistently, studies have demonstrated that patients with bone-only metastasis have prolonged survival and a better prognosis than those with additional visceral metastases [Previous analyses about prognosis of BC patients with bone metastasis clarified that HR+/Her2+ subtype was an independent protection factor of prognosis, and indicated the most favorable prognosis among all subtypes [The development, progression and prognosis of malignancies were closely related to the systemic inflammation, immunity, and nutrition status of patients [MCH means the average amount of hemoglobin content in each red blood cell. With regarding to MCH as a prognostic factor, various studies have reached conflicting conclusions. Recently, Liang et al. [Significantly, the high level of MCV in the univariate Cox regression analysis was determined as a protective factor but as a risk factor in multiple Cox regression analysis. This phenomenon indicated that there were one or more potential confounding factors confusing the true effect of MCV in the univariate analysis, and revealing it as an independent prognostic risk factor after adjustment of multiple analysis. The result of MCV in our final model was consistent with a previous study that preoperative MCV was a poor prognostic factor for esophageal cancer [Inflammation is a recognized hallmark feature of cancer, which plays an important role in the development and progression of malignant tumors, including BC [WBC are widely used peripheral blood indicators to reflect the systemic inflammation. A retrospective study with 6668 patients determined the prognostic value between low WBC and high LY% and the poor prognosis of non-metastatic nasopharyngeal carcinoma [In our study, almost all of the enrolled patients received therapy for primary BC before bone metastasis, such as radiotherapy, chemotherapy, endocrine therapy and surgery. Although different treatments for primary BC may influence the levels of blood indicators, we considered blood indicators tested at the time of bone metastasis diagnosis as baseline level to investigate the association with prognosis of BC bone metastasis, which was consistent with those previous studies [There were several unavoidable limitations in our study. First, this was a single-center retrospective study of which model validation was based on internal validation In conclusion, in this study, we developed a prognostic nomogram of predicting OS of BC patients with bone metastasis, and our study suggested that two clinical features (age and other organ metastasis sites) and six clinical laboratory examination indicators (LDH, GLB, WBC, MCV, MCH, and MO%) could estimate the prognosis among the patients who were undergoing BC bone metastasis. Our model employed a blend of clinical features and laboratory examination indicators that reflect various aspects of a patient’s condition, resulting in enhanced prediction accuracy. Moreover, the Cox regression model results were expressed through a nomogram visualization tool, offering simple and direct interpretation for the clinical doctors. Our nomogram model might assist doctors in assessing the risk factors and prognosis of BC patients with bone metastasis. It might be suggested that patients at high risk based on the nomogram may require more aggressive treatment strategies.