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Comparison between different prognostic models to be used for metastatic bone disease on appendicular skeleton in a Chilean population



Several preoperation prognosis models used on the treatment of metastatic bone disease on appendicular skeleton have been devised. The purpose of this study was to compare the performance of different survival prognostic models on patients with metastatic bone disease in long bones in a Chilean population.


This is a multicentric retrospective study. We retrospectively reviewed the medical records of 136 patients who were confirmed with metastatic bone disease of the appendicular skeleton and who were treated surgically from 2016 to 2019. The minimum follow-up time was 12 months. All patients were assessed using four appendicular metastatic bone disease scoring systems. A preoperative predicted survival time for all 136 patients was retrospectively calculated making use of the revised Katagiri, PathFx, Optimodel and IOR score model.


The PathFx model demonstrated an accuracy at predicting 3 (area under the curve [AUC] = 0.61) and 6-month (AUC = 0.65) survival time after surgical management. IOR score model demonstrated an accuracy at predicting 12-month survival time (AUC = 0.64). The survival rate reached the 44% in a year. The median survival time to death or last follow-up time was 14.9 months (SD ± 15).


PathFx score model demonstrated the highest accuracy at predicting a survival time of 3 and 6 months. IOR score model was the most accurate measure at predicting a survival time of 12-months. To our knowledge, this is the first study reporting a comparative analysis of metastatic bone disease with predicting models in a country located in Latin America. PathFx’s and IOR score models are the ones to be used in the Chilean population as the predictive models in metastatic bone disease of the appendicular skeleton.

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Corresponding author

Correspondence to Patricio A. Alfaro.

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Conflict of interest

Patricio A. Alfaro, Javier Delgado, Andres Dumas, Cecilia Mesa, Orlando Wevar, Carlos Herrera and Fabian Padilla declared not to have financial interests in this project. Eduardo Botello work with consultant honoraria from Company Zimmer-Biomet and Implancast. Also, he is President of the Latin American Orthopedic Musculoskeletal Tumors Society (SLATME), and a member of the Board of the International Society of Limb Salvage (ISOLS) and SICOT Chairman.

Ethical approval

All procedures performed in the study involving human participants were in accordance with both, the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration (considering even its later amendments or comparable ethical standards).

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This research was approved by the local research Ethics Committee to be carried out with waiver of informed consent.

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Alfaro, P.A., Delgado, J., Dumas, A. et al. Comparison between different prognostic models to be used for metastatic bone disease on appendicular skeleton in a Chilean population. Eur J Orthop Surg Traumatol 31, 1657–1662 (2021).

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  • Metastatic bone disease
  • Metastatic cancer
  • Impending and pathologic fractures
  • Prognostic score
  • Skeletal metastases