{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T13:25:55Z","timestamp":1769001955682,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Numerous of models have been developed to predict the bone metastasis (BM) risk; however, due to the variety of cancer types, it is difficult for clinicians to use these models efficiently. We aimed to perform the pan\u2010cancer analysis to create the cancer classification system for BM, and construct the nomogram for predicting the BM risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cancer patients diagnosed between 2010 and 2018 in the Surveillance, Epidemiology, and End Results (SEER) database were included. Unsupervised hierarchical clustering analysis was performed to create the BM prevalence\u2010based cancer classification system (BM\u2010CCS). Multivariable logistic regression was applied to investigate the possible associated factors for BM and construct a nomogram for BM risk prediction. The patients diagnosed between 2017 and 2018 were selected for validating the performance of the BM\u2010CCS and the nomogram, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 50 cancer types with 2,438,680 patients were included in the construction model. Unsupervised hierarchical clustering analysis classified the 50 cancer types into three main phenotypes, namely, categories A, B, and C. The pooled BM prevalence in category A (17.7%; 95% CI: 17.5%\u201317.8%) was significantly higher than that in category B (5.0%; 95% CI: 4.5%\u20135.6%), and category C (1.2%; 95% CI: 1.1%\u20131.4%) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Advanced age, male gender, race, poorly differentiated grade, higher T, N stage, and brain, lung, liver metastasis were significantly associated with BM risk, but the results were not consistent across all cancers. Based on these factors and BM\u2010CCS, we constructed a nomogram for predicting the BM risk. The nomogram showed good calibration and discrimination ability (AUC in validation cohort\u2009=\u200988%,95% CI: 87.4%\u201388.5%; AUC in construction cohort\u2009=\u200986.9%,95% CI: 86.8%\u201387.1%). The decision curve analysis also demonstrated the clinical usefulness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The classification system and prediction nomogram may guide the cancer management and individualized BM screening, thus allocating the medical resources to cancer patients. Moreover, it may also have important implications for studying the etiology of BM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7014","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T11:50:30Z","timestamp":1709293830000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reclassified the phenotypes of cancer types and construct a nomogram for predicting bone metastasis risk: A pan\u2010cancer analysis"],"prefix":"10.1002","volume":"13","author":[{"given":"Ming","family":"Li","sequence":"first","affiliation":[{"name":"Department of General Surgery, Section for HepatoPancreatoBiliary Surgery, The Third People's Hospital of Chengdu Affiliated Hospital of Southwest Jiaotong University &amp; The Second Affiliated Hospital of Chengdu, Chongqing Medical University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenqian","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China Public Health School and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7096-8488","authenticated-orcid":false,"given":"Chao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Bone and Soft Tissue Tumours National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology General Hospital of Western Theater Command  Chengdu P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuchuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology General Hospital of Western Theater Command  Chengdu P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1542-0828","authenticated-orcid":false,"given":"Fengju","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital  Tianjin People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiyi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China Public Health School and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoheng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China Public Health School and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China Public Health School and West China Fourth Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Mao","sequence":"additional","affiliation":[{"name":"The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University  Chengdu 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