A scoring system for screening of patients with synchronous bone metastasis in lung cancer

This study aims to investigate the incidence of and factors associated with bone metastasis (BM) in patients with lung cancer and provide guidance for the screening of BM in patients with lung cancer. Lung cancer patients who were treated at the Tianjin Medical University Cancer Institute and Hospital between 2009 and 2018 were retrospectively reviewed. Patients with synchronous BM were obtained to investigate the risk factors for BM development. Both demographic and clinical characteristics were included. Univariate and multivariate logistic regression analyses were performed to identify risk factors. A further scoring system was established to classify patients into 3 different risk groups. Five significant risk factors were identified, namely, male sex, Karnofsky score of 50 to 70, multiple primary lesions, lymph node metastasis, and adenocarcinoma. The total score was generated by the integration of the score based on each individual factor. The incidence of BM among patients with lung cancer with a total score ≥ 7 was 46.73%, the incidence among patients with a total score ≤ 4 was 16.59%, and the incidence of BM in patients with total scores between 5 and 6 was 34.23%. This scoring system can predict the risk of BM in patients with lung cancer and can guide the performance of BM screening.