ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ
Background. 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 wit...
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| Published in: | Експериментальна онкологія |
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| Date: | 2026 |
| Volume: | 48 |
| Issue: | 2 |
| Pages: | 146-151 |
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Experimental Oncology| _version_ | 1874183247043231744 |
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| author | Vorobchuk, M. Burlaka, A. Diedkov, A. |
| author_facet | Vorobchuk, M. Burlaka, A. Diedkov, A. |
| author_institution_txt_mv | [
{
"author": "M. Vorobchuk",
"institution": "Bogomolets National Medical University, Kyiv, Ukraine",
"orcid": ""
},
{
"author": "A. Burlaka",
"institution": "Bogomolets National Medical University, Kyiv, Ukraine",
"orcid": "0000-0002-2296-7234"
},
{
"author": "A. Diedkov",
"institution": "Nonprofit Organization “National Cancer Institute”, Kyiv, Ukraine",
"orcid": ""
}
] |
| author_orcid_str_mv | 0000-0002-2296-7234 |
| author_sort | Vorobchuk, M. |
| baseUrl_str | https://exp-oncology.com.ua/index.php/Exp/oai |
| collection | OJS |
| container_end_page | 151 |
| container_issue | 2 |
| container_start_page | 146 |
| container_title | Експериментальна онкологія |
| container_volume | 48 |
| datestamp_date | 2026-08-21T12:36:16Z |
| description | Background. 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. Materials and Methods. 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. Results. 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. Conclusion. 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. |
| doi_str_mv | 10.15407/exp-oncology.2026.02.146 |
| first_indexed | 2026-08-22T01:00:26Z |
| format | Article |
| fulltext |
146 ISSN 1812-9269. Experimental Oncology 48 (2). 2026
C i t a t i o n: Vorobchuk M, Burlaka A, Diedkov A. Survival predictors in cancer patients with bone metastasis: Retro-
spective cohort single-center study. Exp Oncol. 2026; 48(2): 146-151. https://doi.org/10.15407/exp-oncology.2026.02.146
© PH “Akademperiodyka” of the NAS of Ukraine, 2026. This is an open access article under the CC BY-NC-ND license
(https://creativecommons.org/licenses/by-nc-nd/4.0/)
ORIGINAL CONTRIBUTION
5.1% of all cancer patients have bone metastasis
(BM) at diagnosis. They occur frequently in breast
cancer (65%—70%), prostate cancer (65%—90%),
lung cancer (17%—64%), renal cell cancer (20%—
25%), and thyroid cancer (65%) [1]. The number
of patients with BM increases as advanced medical
management and radical surgery improve the ove
rall survival (OS) of cancer patients. BM may be a
cause of skeletal-related events like pain syndrome
in bones (60%—84%), pathologic fractures (9%—
29%), spinal cord compression with neurological
disorders (15%—20%), and hypercalcemia (20%),
https://doi.org/10.15407/exp-oncology.2026.02.146
M. Vorobchuk 1, *, A. Burlaka 1, A. Diedkov 2
1 Bogomolets National Medical University, Kyiv, Ukraine
2 Nonprofit Organization “National Cancer Institute”, Kyiv, Ukraine
* Correspondence: E-mail: mykhailo_vorobchuk@ukr.net
SURVIVAL PREDICTORS IN CANCER PATIENTS
WITH BONE METASTASIS: RETROSPECTIVE
COHORT SINGLE-CENTER STUDY
Background. 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. Materials and
Methods. 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. Results. The median overall sur-
vival 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 (me-
dian 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. Conclusion. 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.
Keywords: bone metastasis, survival, prognosis, Kaplan—Meier method, Cox regression, pathologic fracture, oncoor-
thopedics.
https://doi.org/10.15407/exp-oncology.2026.02.146
https://creativecommons.org/licenses/by-nc-nd/4.0/
https://doi.org/10.15407/exp-oncology.2026.02
mailto:mykhailo_vorobchuk@ukr.net
ISSN 1812-9269. Experimental Oncology 48 (2). 2026 147
Survival Predictors in Cancer Patients with Bone Metastasis: Retrospective Cohort Single-Center Study
which adversely affect the quality of life and worsen
the prognosis. The estimated one-year survival fol-
lowing orthopedic surgery is 36% [2]. In Ukraine,
late diagnosis and the lack of unified treatment al-
gorithms adversely affect treatment outcomes for
patients with BM. The differential diagnosis of BM
requires a thorough examination to exclude syn-
chronous or metachronous primary bone neo-
plasms [3]. The use of prognostic tools to assess the
general conditions and survival of patients, as well
as the selection of the appropriate treatment meth-
od, is considered an indispensable component of
the complex approach for the treatment of patients
with BM. The prognosis for survival in such pa-
tients is of great importance in selecting an optimal
treatment strategy to improve the patient’s quality
of life and decrease the risk of postoperative com-
plications [4]. As a method of choice for improving
the quality of life, in certain situations, orthopedic
interventions may even be unfavorable from a
prognostic view [5]. Opposed to surgical methods,
a broad armamentarium of non-surgical treatment
approaches is available depending on the localiza-
tion, size, and number of BM. The aim of the study
was to assess the associations between the type of
primary tumor, the number of BM, the type of sur-
gery, the presence of a pathologic fracture, and the
survival of cancer patients with BM.
Materials and Methods
The retrospective single-center cohort study in-
cluded patients treated at the National Cancer In-
stitute (Kyiv, Ukraine). The patients’ files covering
January 2006 to December 2025 were selected from
the National Cancer Registry. Adult patients
(≥18 years) with metastatic bone lesions and the
following orthopedic interventions were included
in the study. The inclusion criteria were: age
≥18 years, confirmed BM, orthopedic interventions
due to metastatic bone lesions, and availability of
follow-up data. The exclusion criteria were: age
<18 years, primary bone tumor without metastatic
lesions, incompleteness of clinical data, and surger-
ies unrelated to BM treatment.
The clinical data were retrieved from the cancer
registry and the patients’ records. The following data
were taken into account: the demographic charac-
teristics of the patients, type of primary tumor,
the number of metastases (solitary or multiple),
localization of metastases, presence of a patholog-
ical fracture or impending fracture, type of sur-
gery, prior cancer treatment, postoperative com-
plications, and dates of surgery and last follow-up
or date of death. The surgery was attributed to one
of the two major types — endoprosthetics and os-
teosynthesis. In the survival analysis of the pre
sent study, cases of plate fixation and interlocking
intramedullary nailing were combined into a sin-
gle osteosynthesis group. The follow-up period
was calculated from the surgery date to the date
of the last visit or the date of death. The patients
alive at the end of the present study were consi
dered censored in the survival analysis. The pri-
mary endpoint for the analysis was the OS. The
postoperative complications, such as implant fai
lure, local tumor progression, metal-associated in-
fection, or endoprosthesis dislocation, were con-
sidered secondary endpoints.
The data were loaded and analyzed in Microsoft
Excel. For statistical processing, Python (3.x ver-
sion) was used with pandas, numpy, lifelines, and
matplotlib libraries. Survival was assessed by the
Kaplan–Meier method, with survival curves com-
pared by the log-rank test. The effects of prognos-
tic factors were evaluated by the Cox proportional
hazards model. The multivariate analysis included
the following independent OS predictors: the type
of primary tumor, number of metastases (solitary
or multiple), presence of a pathological fracture
or impending fracture, type of surgery, and prior
cancer treatment. The results were presented as a
hazard ratio (HR) with a 95% confidence interval
(CI). The assumption of hazard proportionality
was checked graphically. The difference was con-
sidered significant at p < 0.05.
Results
Of the 187 patients with orthopedic surgery due to
metastatic bone lesions, 136 patients were included
in this study. The most frequent primary tumor in
our study was renal cancer (39.7%), followed by
breast cancer (23.5%), bone cancer/sarcoma (8.1%),
and lung cancer (3.7%). Other cancers (prostate,
uterine, colorectal, thyroid cancers, and CNS tu-
mors, etc.) accounted for the rest of 25% of the cas-
es. In 82 patients (60.3%), BMs were solitary, and
in 52 (38.2%) — multiple. In two cases, the BM
number was not recorded in the files. 93 patients
148 ISSN 1812-9269. Experimental Oncology 48 (2). 2026
M. Vorobchuk, A. Burlaka, A. Diedkov
(68.4%) were hospitalized due to pathological frac-
tures, while 43 patients (31.6%) were treated be-
cause of the risk of pathological fractures. The fol-
lowing types of surgery were performed to treat
metastatic bone lesions: plate fixation (50.7%), en-
doprosthetics (35.5%), and interlocking intrame
dullary nailing (5.9%). In 8.1% of cases, other tech-
niques were utilized. 64.7% of surgical interven-
tions were radical and 34.3% palliative.
The OS median in patients who underwent or-
thopedic surgery for metastatic bone lesions was
32.8 months (Fig. 1). Patients with solitary metas-
tases had significantly better OS than those with
multiple metastases (median 44.8 vs 18.4 months,
p = 0.021) (Fig. 2).
The presence of a pathologic fracture was as-
sociated with a significant decrease in OS. The OS
median in patients with pathologic fractures was
significantly less compared to patients with im-
pending fractures (25.4 months vs 64.6 months,
p = 0.014) (Fig. 3).
OS varied significantly in patients with diffe
rent types of primary tumors, with the longest
median (41.2 months) in breast cancer and the
shortest median (18.1 months) in lung cancer
(Fig. 4). Among the studied patients, in 40 cases
(29.4%), surgery was the only modality of the pre-
vious treatment of the underlying disease, while
in 96 patients (70.6%), a combined treatment was
employed. Although there was no significant dif-
ference in OS depending on the previous treat-
ment (single modality vs combined modality,
p = 0.505) (Fig. 5), in the multivariate analysis,
combined treatment was identified as an indepen-
dent factor associated with a decreased risk of
death. This discrepancy may be explained by the
non-homogeneous distribution of prognostically
unfavorable factors among the groups.
Osteosynthesis (plate fixation and interlocking
intramedullary nailing) was performed in 77 pa-
tients, while endoprosthetics — in 48 patients. In
the osteosynthesis group, the OS median was
32.3 months, and in the endoprosthetics group —
41.2 months. Nevertheless, despite the trend of bet-
ter survival in the endoprosthetics group, the dif-
ference was not significant (p = 0.386) (Fig. 6).
Multivariate logistic regression was used to find
out independent unfavorable predictors (Table).
The following factors were identified as the most
significant independent unfavorable predictors:
multiple metastases (HR 2.13; 95% CI 1.30—3.50;
p = 0.003) and the presence of a pathological frac-
ture (HR 1.81; 95% CI 1.04—3.14; p = 0.036). The
combined previous treatment (surgery + other
modalities) was significantly associated with a de-
Fig. 1. The Kaplan—Meier analysis of OS in patients who un-
derwent orthopedic surgery due to metastatic bone lesions
Fig. 2. The Kaplan—Meier curves for comparison of OS for
patients with solitary and multiple metastases (p = 0.021)
Fig. 3. The Kaplan—Meier curves demonstrating OS de-
pending on fracture status (pathological fracture vs im-
pending fracture). p = 0.014
ISSN 1812-9269. Experimental Oncology 48 (2). 2026 149
Survival Predictors in Cancer Patients with Bone Metastasis: Retrospective Cohort Single-Center Study
crease in the risk of death compared to surgery
only (HR 0.47; 95% CІ 0.25—0.90; p = 0.023). Nei-
ther the type of cancer nor the type of surgery was
an independent OS predictor (Table, Fig. 7).
Complications were registered in 18 patients of
136 (13.2%). The most frequent type of complica-
tions was the fracture of the metal plate (9 cases).
In 5 cases, local tumor progression at the resection
site occurred. There were three cases of metal-as-
sociated infection and one case of dislocation of the
endoprosthesis head.
Discussion
We have analyzed factors affecting the survival of
patients with BM after orthopedic surgery. The
number of metastases, the presence of a pathologi-
cal fracture, and the type of previous treatment
were identified as the most significant predictors
Fig. 4. The Kaplan—Meier curves demonstrating OS de-
pending on the tumor type
Fig. 7. The forest plot of multivariate logistic Cox regres-
sion analysis of OS
Fig. 5. The Kaplan—Meier curves demonstrating OS de-
pending on the modality of the previous treatment for pri-
mary tumor (surgery alone vs combined treatment). The
OS difference is not significant (p = 0.505)
Risk factors associated with OS
(multivariate logistic regression analysis)
Variables HR 95% CI p
Renal cancer vs breast
cancer
0.77 0.40—1.48 0.429
Lung cancer vs breast
cancer
2.39 0.78—7.34 0.127
Bone cancer vs breast
cancer
0.64 0.27—1.54 0.320
Other cancers vs breast
cancer
1.25 0.65—2.37 0.506
Multiple metastases vs
solitary metastases
2.13 1.30—3.50 0.003
Pathological fracture vs
impending fracture
1.81 1.04—3.14 0.036
Combined treatment vs
surgery only
0.47 0.25—0.90 0.023
Endoprosthetics vs
osteosynthesis
0.94 0.57—1.56 0.812
Fig. 6. The Kaplan—Meier curves demonstrating OS of
patients with BM in groups of osteosynthesis and endo-
prosthetics (p = 0.386)
150 ISSN 1812-9269. Experimental Oncology 48 (2). 2026
M. Vorobchuk, A. Burlaka, A. Diedkov
of OS. In our study, OS was slightly higher than in
several international clinical studies [1, 6—10].
This may be explained by the peculiarities of pa-
tient selection, particularly the inclusion of patients
with a more favorable prognosis and predominant-
ly solitary metastases. Our results confirmed that
the number of metastatic lesions is a key prognostic
factor. This aligns with the literature, which reports
worse survival in patients with multiple metastases
[7, 9]. The pathological fracture identified as an in-
dependent unfavorable prognostic factor in our
study is consistent with the data from Raschka et
al. [10] and the conclusions of the current meta-
analysis [11]. Unadjusted Cox proportional hazards
regression analysis did not reveal a significant dif-
ference by the modality of the previous treatment
for the primary tumor (surgery alone vs combined
treatment). Nevertheless, the multivariate analysis
demonstrated a significant decrease in the risk of
death in patients who received combined treat-
ment. This may be explained by the effect of con-
founding factors [1, 6]. The OS varied depending
on the type of primary tumor, as shown earlier in
several studies [5, 7]. It should be noted that the
distribution by the types of cancer in our cohort, in
general, is consistent with that in other studies.
Nevertheless, in our study, the proportion of cases
of prostate and thyroid cancer was relatively low,
although these cancer types are frequently associated
with BM [1, 5]. The OS rates for different cancer
types were generally compatible with those in other
studies, namely, a better prognosis was for breast
cancer and renal cancer, while the worst one was for
lung cancer [9, 12]. The absence of a significant dif-
ference among the surgery types agrees with the data
by Raschka et al. [10]. The rate of postoperative
complications (13.2%) was within the range of this
parameter in other studies (10% — 20%) [10, 13, 14].
Our results highlight the importance of a multidis-
ciplinary approach in the treatment of patients with
BM [1, 13, 15].
Although there are some limitations in our study,
in particular, its retrospective design and single-
center pattern, our findings may serve as the basis
for the development of clinically oriented prognos-
tic models.
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Submitted: April 10, 2026
М. Воробчук 1, А. Бурлака 1, А. Дєдков 2
1 Національний медичний університет
ім. О.О. Богомольця, Київ, Україна
2 Державне некомерційне підприємство
«Національний інститут раку», Київ, Україна
ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ
ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ
НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ
МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ
Стан питання. Метастатичне ураження кісток є частим ускладненням злоякісних новоутворень, асоційова-
ним зі значним зниженням якості життя й виживаності пацієнтів. Прогнозування виживаності пацієнтів є
ключовим для вибору оптимальної тактики лікування, зокрема ортопедичних втручань. Метою дослідження
було визначити прогностичні фактори загальної виживаності в пацієнтів із метастазами в кістки, яким вико-
нано ортопедичні хірургічні втручання. Матеріали та методи. Проведено ретроспективне когортне моноцен-
трове дослідження 136 пацієнтів із кістковими метастазами, прооперованих у Національному інституті раку
(Київ, Україна) в період від 2006 до 2025 року. Аналізували вплив типу первинної пухлини, кількості метастазів,
наявності патологічного перелому, виду попереднього лікування та типу оперативного втручання на загаль-
ну виживаність. Виживаність оцінювали методом Каплана—Мейєра, порівняння груп — за допомогою лог-
рангового критерію. Для визначення незалежних прогностичних факторів використовували багатофакторну
регресію Кокса. Результати. Медіана загальної виживаності становила 32,8 місяця. Пацієнти із солітарними ме-
тастазами мали достовірно кращу виживаність порівняно з пацієнтами з множинними метастазами (медіана
44,8 проти 18,4 місяця; p = 0,021). Наявність патологічного перелому асоціювалася зі зниженням виживаності
(25,4 проти 64,6 місяця; p = 0,014). У багатофакторному аналізі незалежними несприятливими факторами були
множинні метастази (HR 1,95; 95% ДІ 1,18—3,22; p = 0,009) та патологічний перелом (HR 1,82; 95% ДІ 1,05—3,17;
p = 0,034). Комбіноване лікування асоціювалося зі зниженням ризику смерті (HR 0,48; 95% ДІ 0,26—0,91; p =
= 0,023). Висновки. Отримані результати можуть бути використані для стратифікації ризику та персоналізації
лікування у пацієнтів із метастазами в кістки, яким виконано ортопедичні хірургічні втручання.
Ключові слова: кісткові метастази, виживаність, метод Каплана—Мейєра, регресія Кокса, патологічний пере-
лом, онкоортопедія.
https://doi.org/10.1007/s11999-007-0051-0
https://doi.org/10.1097/AJP.0000000000000255
https://doi.org/10.1097/AJP.0000000000000255
https://doi.org/10.3109/17453674.2013.788437
https://doi.org/10.1097/CORR.0000000000003030
https://doi.org/10.1097/CORR.0000000000003030
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| id | oai:ojs2.ex.aqua-time.com.ua:article-649 |
| institution | Experimental Oncology |
| issn | 2312-8852 |
| keywords_txt_mv | |
| language | English |
| last_indexed | 2026-08-22T01:00:26Z |
| publishDate | 2026 |
| publisher | PH Akademperiodyka |
| record_format | ojs |
| resource_txt_mv | exp-oncologycomua/fe/b2e771a518ea31cebfed965bb94854fe.pdf |
| spelling | oai:ojs2.ex.aqua-time.com.ua:article-6492026-08-21T12:36:16Z SURVIVAL PREDICTORS IN CANCER PATIENTS WITH BONE METASTASIS: RETROSPECTIVE COHORT SINGLE-CENTER STUDY ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ Vorobchuk, M. Burlaka, A. Diedkov, A. кісткові метастази, виживаність, метод Каплана—Мейєра, регресія Кокса, патологічний перелом, онкоортопедія. bone metastasis, survival, prognosis, Kaplan—Meier method, Cox regression, pathologic fracture, oncoorthopedics Background. 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. Materials and Methods. 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. Results. 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. Conclusion. 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. Стан питання. Метастатичне ураження кісток є частим ускладненням злоякісних новоутворень, асоційованим зі значним зниженням якості життя й виживаності пацієнтів. Прогнозування виживаності пацієнтів є ключовим для вибору оптимальної тактики лікування, зокрема ортопедичних втручань. Метою дослідження було визначити прогностичні фактори загальної виживаності в пацієнтів із метастазами в кістки, яким виконано ортопедичні хірургічні втручання. Матеріали та методи. Проведено ретроспективне когортне моноцентрове дослідження 136 пацієнтів із кістковими метастазами, прооперованих у Національному інституті раку (Київ, Україна) в період від 2006 до 2025 року. Аналізували вплив типу первинної пухлини, кількості метастазів, наявності патологічного перелому, виду попереднього лікування та типу оперативного втручання на загальну виживаність. Виживаність оцінювали методом Каплана—Мейєра, порівняння груп — за допомогою логрангового критерію. Для визначення незалежних прогностичних факторів використовували багатофакторну регресію Кокса. Результати. Медіана загальної виживаності становила 32,8 місяця. Пацієнти із солітарними метастазами мали достовірно кращу виживаність порівняно з пацієнтами з множинними метастазами (медіана 44,8 проти 18,4 місяця; p = 0,021). Наявність патологічного перелому асоціювалася зі зниженням виживаності (25,4 проти 64,6 місяця; p = 0,014). У багатофакторному аналізі незалежними несприятливими факторами були множинні метастази (HR 1,95; 95% ДІ 1,18—3,22; p = 0,009) та патологічний перелом (HR 1,82; 95% ДІ 1,05—3,17; p = 0,034). Комбіноване лікування асоціювалося зі зниженням ризику смерті (HR 0,48; 95% ДІ 0,26—0,91; p = 0,023). Висновки. Отримані результати можуть бути використані для стратифікації ризику та персоналізації лікування у пацієнтів із метастазами в кістки, яким виконано ортопедичні хірургічні втручання. PH Akademperiodyka 2026-08-21 Article Article application/pdf https://exp-oncology.com.ua/index.php/Exp/article/view/649 10.15407/exp-oncology.2026.02.146 Experimental Oncology; Vol. 48 No. 2 (2026): Experimental Oncology; 146-151 Експериментальна онкологія; Том 48 № 2 (2026): Експериментальна онкологія; 146-151 2312-8852 1812-9269 10.15407/exp-oncology.2026.02 en https://exp-oncology.com.ua/index.php/Exp/article/view/649/475 Copyright (c) 2026 Experimental Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| spellingShingle | кісткові метастази виживаність метод Каплана—Мейєра регресія Кокса патологічний перелом онкоортопедія. Vorobchuk, M. Burlaka, A. Diedkov, A. ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ |
| title | ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ |
| title_alt | SURVIVAL PREDICTORS IN CANCER PATIENTS WITH BONE METASTASIS: RETROSPECTIVE COHORT SINGLE-CENTER STUDY |
| title_full | ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ |
| title_fullStr | ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ |
| title_full_unstemmed | ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ |
| title_short | ПРЕДИКТОРИ ВИЖИВАНОСТІ ПАЦІЄНТІВ ІЗ КІСТКОВИМИ МЕТАСТАЗАМИ ЗЛОЯКІСНИХ НОВОУТВОРЕНЬ: РЕТРОСПЕКТИВНЕ КОГОРТНЕ МОНОЦЕНТРОВЕ ДОСЛІДЖЕННЯ |
| title_sort | предиктори виживаності пацієнтів із кістковими метастазами злоякісних новоутворень: ретроспективне когортне моноцентрове дослідження |
| topic | кісткові метастази виживаність метод Каплана—Мейєра регресія Кокса патологічний перелом онкоортопедія. |
| topic_facet | кісткові метастази виживаність метод Каплана—Мейєра регресія Кокса патологічний перелом онкоортопедія. bone metastasis survival prognosis Kaplan—Meier method Cox regression pathologic fracture oncoorthopedics |
| url | https://exp-oncology.com.ua/index.php/Exp/article/view/649 |
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