{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:53:52Z","timestamp":1781877232108,"version":"3.54.5"},"reference-count":36,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Program Project of Science and Technology Innovation Guidance of Zhengzhou City","award":["2024YLZDJH175"],"award-info":[{"award-number":["2024YLZDJH175"]}]},{"DOI":"10.13039\/501100013066","name":"Key Scientific Research Project of Colleges and Universities in Henan Province","doi-asserted-by":"crossref","award":["26A310002"],"award-info":[{"award-number":["26A310002"]}],"id":[{"id":"10.13039\/501100013066","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Plan of Science and Technology of Kaifeng City","award":["2503167"],"award-info":[{"award-number":["2503167"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to establish a diagnostic nomogram for identifying synchronous lung metastasis at initial diagnosis in osteosarcoma patients, and to descriptively analyze overall survival patterns in patient subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 1149 eligible osteosarcoma cases diagnosed between 2010 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Candidate predictors were screened by univariate logistic regression (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.10) and entered into backward stepwise multivariate logistic regression (retention\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05) to construct a diagnostic nomogram. Discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), calibration by calibration plot, and clinical utility by decision curve analysis (DCA) with bootstrapping validation. Secondary survival analysis used Kaplan-Meier curves and log-rank tests to describe overall survival patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Synchronous lung metastases were found in 213 patients (18.5%) at diagnosis. The nomogram incorporated age, race, sex, lymph node stage, grade, tumour size, tumour site, and histology. It achieved an AUC of 0.754 (95% confidence interval 0.719 - 0.799) and a bootstrap-calibrated C-index of 0.745. Calibration was satisfactory, and DCA demonstrated superior net benefit compared with traditional staging approaches, including AJCC stage, grade alone, size alone, and N stage alone. In exploratory survival analysis, patients with synchronous metastasis had significantly poorer overall survival, and primary tumour surgery was associated with prolonged median survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The diagnostic nomogram, incorporating tumour grade, site, size, and lymph node stage, provides a reliable tool for estimating the probability of synchronous lung metastasis at initial diagnosis, which may assist clinicians in guiding initial staging intensity and treatment planning. However, owing to the cross-sectional design of the SEER database, this model is not designed for predicting future metastatic progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261462612","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:43:05Z","timestamp":1781710985000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A diagnostic nomogram for synchronous lung metastasis at initial diagnosis in osteosarcoma: A retrospective SEER database study"],"prefix":"10.1177","volume":"34","author":[{"given":"Sisi","family":"Ge","sequence":"first","affiliation":[{"name":"Zhengzhou Health Vocational College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Yu","sequence":"additional","affiliation":[{"name":"Zhengzhou Orthopaedic Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Hu","sequence":"additional","affiliation":[{"name":"Henan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8667-553X","authenticated-orcid":false,"given":"Yanli","family":"Niu","sequence":"additional","affiliation":[{"name":"Henan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2025.01.009"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00409-y"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2026.105252"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2103423"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.08.1995"},{"issue":"2","key":"e_1_3_6_7_2","first-page":"e20210478","article-title":"Pulmonary metastasis of osteosarcoma: multiple presentations in a single patient","volume":"48","author":"Silva JAM","year":"2022","unstructured":"Silva JAM, Marchiori E, Macedo FC, et al. 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