In this model, low albumin, high leukocyte, high PLR, high NLR, high SII, high TPSA, high SCC, high Ca199, high CEA, high Cyfra211, age ≥ 65, male, KPS < 80, smoking, N1–3, T3–4, non-adenocarcinoma, presence of brain metastasis, bone metastasis, adrenal metastasis, liver metastasis, SM−, and metastatic sites receiving partial or no LT before PD were assigned in level 2, and the corresponding alternatives were assigned in level 1. The gene discussed is CEACAM5; the disease is bone metastasis.