SURVIVAL PREDICTORS IN CANCER PATIENTS WITH BONE METASTASIS: RETROSPECTIVE COHORT SINGLE-CENTER STUDY

Bone metastasis, a frequent complication in cancer patients, is associated with a significant decline in quality of life and reduced survival. Overall survival prognosis is critical for selecting the optimal treatment strategy, particularly for planning orthopedic surgery in patients with bone metastasis. The aim of the study was to delineate prognostic factors for overall survival in patients with bone metastasis following orthopedic surgery.

136 patients with bone metastasis treated at the National Cancer Institute (Ukraine) between 2006 and 2025 were included in a retrospective, single-center cohort study. The effects of the primary tumor type, number of metastases, presence of a pathologic fracture, prior treatment, and type of surgery on overall survival were assessed. Survival was analyzed using the Kaplan-Meier method, and the log-rank test was used for group comparisons. Multivariate Cox regression was used to identify independent prognostic factors.

The median overall survival was 32.8 months. Patients with solitary metastases had significantly better survival than those with multiple metastases (median 44.8 vs 18.4 months; p = 0.021). Pathologic fractures were associated with worse survival (median 25.4 vs 64.6 months; p = 0.014). In multivariate analysis, multiple metastases (HR 1.95; 95% CI 1.18-3.22; p = 0.009) and pathologic fractures (HR 1.82; 95% CI 1.05-3.17; p = 0.034) were identified as independent adverse factors. Combined treatment was associated with a lower risk of death (HR 0.48; 95% CI 0.26-0.91; p = 0.023). The type of surgery was not an independent factor affecting survival.

The number of metastases and the presence of a pathologic fracture are key prognostic factors affecting survival in patients with bone metastasis. The results delineating prognostic factors in patients with bone metastasis may be useful for risk stratification and personalized treatment.