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For the 1-month time point, DCA of the Japanese dataset suggested expect better outcomes assuming all patients will survive greater than one month. Brier scores for each curve demonstrate that the models are accurate at each time point. Statement of Clinical Significance- We successfully transitioned to PATHFx 2.0 using open source software and externally validated it in two unique patient populations, which can be used as a cost effective option to guide surgical decisions in patients with metastatic bone disease. This article is prot