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SCORING SYSTEMS Table 2. Primary tumors and median survival times. ACUP: adenocarcinoma of unknown primary. CI:
confidence interval.
Breast
Lung
Prostate
Kidney
Colon
Urothelial cell carcinoma ACUP
Melanoma Pancreaticobiliary Esophagus Thyroid
Stomach
Hepatocellular carcinoma Ewing sarcoma Osteosarcoma
Ovary
Cervix
Uterus sarcoma Endometrium
Tongue
Liposarcoma
388 (28) 318 (23) 259 (19) 90 (7) 73 (5) 36 (3) 31 (2) 28 (2) 28 (2) 27 (2) 15 (1) 14 (1) 13 (<1) 12 (<1) 9 (<1)
9 (<1) 8 (<1) 8 (<1) 6 (<1) 4 (<1) 3 (<1)
18.6 (15.8-21.4) 2.0 (1.6-2.4) 7.4 (5.9-9.0) 7.8 (4.2-11.3) 3.1 (2.3-3.9) 1.7 (0.9-2.5) 2.8 (1.9-3.6) 1.5 (0.2-2.8) 2.5 (1.7-3.3) 2.1 (1.1-3.0) 7.3 (0.0-22.3) 1.4 (0.0-3.4) 4.8 (3.9-5.7) 2.7 (0.3-5.1) 6.3 (0.0-12.6) 5.4 (4.1-6.6) 2.3 (0.0-7.7) 7.2 (0.8-13.5) 1.9 (0.0-17.7) 0.8 (0.0-2.8) 13.4 (0.0-34.7)
Primary
N (%)
Median survival (95%CI)
Median follow-up from start of treatment was 6.7 years (95%CI 5.6-7.7) with a minimum of 2.3 years and a maximum of 12.3 years. Six patients moved abroad after treatment and were lost to follow-up. The overall median survival was 5.1 months (95%CI 4.6-5.6) (figure 1). A total of 1318 patients (96%) died during follow-up. Within two months after starting treatment, 379 patients (27%) died, whereas 257 patients (19%) survived for more than two years.
Multivariate analysis of each separate model showed that the primary tumor, performance status, the presence of visceral metastases and the time to development of SBM were associated with survival. Neurological functioning or ambulatory status, the number of spinal bone metastases and the number of extraspinal bone metastases were not significantly associated with survival in any of the models (table 3).
The median survival times and corresponding hazard ratios for each subgroup of all six models are shown in table 4. Even though all models are able to distinguish between short and long expected survival, the number of patients in each category differs greatly. Model based survival curves are shown in figures 2A-2F.
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