Bone metastasis in advanced cancer is challenging because of pain, functional issues, and reduced life expectancy. Treatment planning is complex, with consideration of factors such as location, symptoms, and prognosis. Prognostic models help guide treatment choices, with Skeletal Oncology Research Group machine-learning algorithms (SORG-MLAs) showing promise in predicting survival for initial spinal metastases and extremity metastases treated with surgery or radiotherapy. Improved therapies extend patient lifespans, increasing the risk of subsequent skeletal-related events (SREs). Patients experiencing subsequent SREs often suffer from disease progression, indicating a deteriorating condition. For these patients, a thorough evaluation, including accurate survival prediction, is essential to determine the most appropriate treatment and avoid aggressive surgical treatment for patients with a poor survival likelihood. Patients experiencing subsequent SREs often suffer from disease progression, indicating a deteriorating condition. However, some variables in the SORG prediction model, such as tumor histology, visceral metastasis, and previous systemic therapies, might remain consistent between initial and subsequent SREs. Given the prognostic difference between patients with and without a subsequent SRE, the efficacy of established prognostic models-originally designed for individuals with an initial SRE-in addressing a subsequent SRE remains uncertain. Therefore, it is crucial to verify the model's utility for subsequent SREs.

中文翻译：

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当前的生存预测工具在治疗骨转移引起的后续骨骼相关事件时有用吗？

由于疼痛、功能问题和预期寿命缩短，晚期癌症的骨转移具有挑战性。治疗计划很复杂，需要考虑位置、症状和预后等因素。预后模型有助于指导治疗选择，骨骼肿瘤学研究小组的机器学习算法 (SORG-MLA) 在预测手术或放疗治疗的初始脊柱转移瘤和四肢转移瘤的生存方面表现出了希望。改进的治疗方法可以延长患者的寿命，但会增加随后发生骨骼相关事件 (SRE) 的风险。经历后续 SRE 的患者通常会出现疾病进展，表明病情恶化。对于这些患者，全面的评估（包括准确的生存预测）对于确定最合适的治疗方法并避免对生存可能性较差的患者进行积极的手术治疗至关重要。经历后续 SRE 的患者通常会出现疾病进展，表明病情恶化。然而，SORG 预测模型中的一些变量，例如肿瘤组织学、内脏转移和先前的全身治疗，可能在初始和后续 SRE 之间保持一致。考虑到随后发生和未发生 SRE 的患者之间的预后差异，已建立的预后模型（最初是为初次发生 SRE 的个体设计的）在解决后续 SRE 方面的功效仍然不确定。因此，验证模型对于后续 SRE 的实用性至关重要。