{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:26:39Z","timestamp":1759364799214,"version":"build-2065373602"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with endometrial cancer bone metastases (ECBM) are clinically rare and have a poor prognosis, including a higher incidence of early death (survival \u2264 3 months). Currently, no practical tools exist to predict early mortality in these patients. Thus, there is an urgent need to develop clinically applicable predictive models, such as nomograms, for individualized assessment of early death risk in ECBM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Relevant clinical and pathological data for ECBM patients from the SEER database (2010-2021). Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with early death in ECBM patients and to construct prognostic nomograms. ROC analysis, calibration curves, and decision curve analysis (DCA) were used to assess the predictive accuracy and clinical utility of the nomogram model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,201 ECBM patients were found in the SEER database. After applying strict exclusion criteria, 769 patients were finally included in this study. Patients were randomly divided into training and validation cohorts in a 7:3 ratio. The results of univariate and multivariate logistic regression analyses revealed several independent predictive factors for early death. For both overall early death (OED) and cancer-specific early death (CSED), protective factors included surgery (OED: OR\u00a0=\u00a00.22, 95%CI: 0.12-0.41, p&amp;lt;0.001; CSED: OR\u00a0=\u00a00.33, 95%CI: 0.18-0.61, p&amp;lt;0.001) and chemotherapy (OED: OR\u00a0=\u00a00.11, 95%CI: 0.06-0.18, p&amp;lt;0.001; CSED: OR\u00a0=\u00a00.14, 95%CI: 0.09-0.24, p&amp;lt;0.001). Brain metastases increased risk (OED: OR\u00a0=\u00a02.98, 95%CI: 1.29-6.87, p=0.01; CSED: OR\u00a0=\u00a02.20, 95%CI: 1.04-4.79, p=0.047). Compared to 0\u20139 days, longer time from diagnosis to treatment showed protective associations: 10\u201327 days (OED: OR\u00a0=\u00a00.51, 95%CI: 0.27-0.98, p=0.042) and \u226528 days (OED: OR\u00a0=\u00a00.23, 95%CI: 0.12-0.44, p&amp;lt;0.001; CSED: OR\u00a0=\u00a00.30, 95%CI: 0.16-0.56, p&amp;lt;0.001). Regarding histological type, compared to endometrioid subtype, sarcomatous subtype significantly increased OED risk (OR\u00a0=\u00a03.04, 95%CI: 1.40-6.57, p=0.005), while radiotherapy reduced CSED risk (OR\u00a0=\u00a00.55, 95%CI: 0.33-0.92, p=0.022). Based on these variables, nomograms were developed to predict the risk of early death. The ROC curve confirmed the model\u2019s high predictive accuracy, while the calibration curve showed strong alignment between predicted and actual survival. DCA further demonstrated its clinical utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, we developed robust nomogram models to predict the probability of early death in ECBM patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1613843","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T04:17:15Z","timestamp":1759292235000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Establishment and validation of a nomogram model for predicting early death in patients with endometrial cancer bone metastases"],"prefix":"10.3389","volume":"15","author":[{"given":"Qi","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yating","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingchun","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.3390\/jcm12062241","article-title":"Recent advances in endometrial cancer management","volume":"12","author":"Di Donato","year":"2023","journal-title":"J Clin Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21708","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.7254","article-title":"Current evidence-based systemic therapy for advanced and recurrent endometrial cancer","volume":"21","author":"Gordhandas","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"key":"B4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1002\/ijgo.13084","article-title":"Prognostic value of distant metastatic sites in stage iv endometrial cancer: A seer database study of 2948 women","volume":"149","author":"Liu","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"key":"B5","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.ejogrb.2023.11.014","article-title":"12-Year Follow up after Successful Treatment of Stage Ivc Endometrial Cancer with Bone Metastasis: A Case Report","volume":"292","author":"Vuji\u0107","year":"2024","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2020-0017","article-title":"Clinicopathological study of organ metastasis in endometrial cancer","volume":"16","author":"Mao","year":"2020","journal-title":"Future Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/coc.0000000000001058","article-title":"A web-based prediction model for early death in patients with metastatic triple-negative breast cancer","volume":"47","author":"Pan","year":"2024","journal-title":"Am J Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s40779-023-00488-2","article-title":"How to use the surveillance, epidemiology, and end results (Seer) data: research design and methodology","volume":"10","author":"Che","year":"2023","journal-title":"Mil Med Res"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.608548","article-title":"A novel tool to predict early death in uterine sarcoma patients: A surveillance, epidemiology, and end results-based study","volume":"10","author":"Song","year":"2020","journal-title":"Front Oncol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"6823","DOI":"10.3390\/ijerph19116823","article-title":"Bone metastases of endometrial carcinoma treated by surgery: A report on 13 patients and a review of the medical literature","volume":"19","author":"Wang","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.694718","article-title":"Clinicopathological characteristics and prognosis in endometrial cancer with bone metastasis: A seer-based study of 584 women","volume":"11","author":"Hu","year":"2021","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2023.2204937","article-title":"Survival benefit of surgical treatment for patients with stage ivb endometrial cancer: A propensity score-matched seer database analysis","volume":"43","author":"Zhang","year":"2023","journal-title":"J Obstet Gynaecol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2023.100485","article-title":"Therapeutic approaches in patients with bone metastasis due to endometrial carcinoma -a systematic review","volume":"41","author":"Heidinger","year":"2023","journal-title":"J Bone Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0038","article-title":"NCCN Guidelines\u00ae Insights: Uterine Neoplasms, Version 3.2025","volume":"23","author":"Abu-Rustum","year":"2024","journal-title":"J Natl Compr Canc Netw."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2024.02.006","article-title":"Adding immunotherapy to first-line treatment of advanced and metastatic endometrial cancer","volume":"35","author":"Bogani","year":"2024","journal-title":"Ann Oncol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.prro.2022.09.002","article-title":"Radiation therapy for endometrial cancer: an american society for radiation oncology clinical practice guideline","volume":"13","author":"Harkenrider","year":"2023","journal-title":"Pract Radiat Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15264","article-title":"Incidence, risk factors, and a prognostic nomogram for distant metastasis in endometrial cancer: A seer-based study","volume":"165","author":"Zheng","year":"2024","journal-title":"Int J Gynaecol Obstet"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000027185","article-title":"Diagnostic and prognostic factors, and two nomograms for endometrial cancer patients with bone metastasis: A large cohort retrospective study","volume":"100","author":"Yang","year":"2021","journal-title":"Med (Baltimore)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.07.019","article-title":"Bone health in cancer: esmo clinical practice guidelines","volume":"31","author":"Coleman","year":"2020","journal-title":"Ann Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1200\/jco.20.00818","article-title":"Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: long-term results of the sabr-comet phase ii randomized trial","volume":"38","author":"Palma","year":"2020","journal-title":"J Clin Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-024-01214-3","article-title":"Current treatment options: uterine sarcoma","volume":"25","author":"Lewis","year":"2024","journal-title":"Curr Treat Options Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v7.i14.1753","article-title":"Current status of the adjuvant therapy in uterine sarcoma: A literature review","volume":"7","author":"Rizzo","year":"2019","journal-title":"World J Clin cases"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1001791","article-title":"Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database","volume":"9","author":"Zhang","year":"2022","journal-title":"Front Surg"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.11.087","article-title":"Brain metastases from endometrial cancer: clinical characteristics, outcomes, and review of the literature","volume":"147","author":"Bhambhvani","year":"2021","journal-title":"World Neurosurg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2024.104533","article-title":"Endometrial cancer in the elderly: characteristics, prognostic and risk factors, and treatment options","volume":"204","author":"Forte","year":"2024","journal-title":"Crit Rev Oncol Hematol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0318632","article-title":"Identifying risk factors for cancer-specific early death in patients with advanced endometrial cancer: A preliminary predictive model based on seer data","volume":"20","author":"Yang","year":"2025","journal-title":"PloS One"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2024.35.e84","article-title":"Prognostic values of tumor size and location in early stage endometrial cancer patients who received radiotherapy","volume":"35","author":"Jiao","year":"2024","journal-title":"J Gynecol Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.978140","article-title":"Survival nomogram for endometrial cancer with lung metastasis: A seer database analysis","volume":"12","author":"Yan","year":"2022","journal-title":"Front Oncol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.03.003","article-title":"Racial and ethnic differences in early death among gynecologic Malignancy","volume":"231","author":"Lee","year":"2024","journal-title":"Am J Obstet Gynecol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1613843\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T04:17:16Z","timestamp":1759292236000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1613843\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":29,"alternative-id":["10.3389\/fonc.2025.1613843"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1613843","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,1]]},"article-number":"1613843"}}