Factors Associated with Revision Surgery in Long Bones Metastases

Abstract

Topicality:
 Bones, as an organ, are one of the most common targets for tumor metastasis. At present, the number of patients undergoing surgical treatment for metastatic bone lesions is steadily increasing. In most patients, after surgical treatment, clinical symptoms (primarily pain) are relieved, which improves patients quality of life. However, it should be noted that the number of patients with bone metastases who underwent repeated surgery is also increasing. This article retrospectively analyzes the factors leading to repeated operations after surgical treatment of metastases in long bones.
 Materials and methods:
 A retrospective analysis of clinical data is based on 247 patients who were carried out surgical treatment of metastases in long bones in MNII. P.A. Herzen during 2006-2020. Among the patients, 33 of them were treated with re-surgical interventions. Including Men - 15, women - 18. The average age is 62. The location of the primary tumor was as follows: breast cancer - 10 patients, kidney cancer - 13 patients, lung cancer - 3 patients, cancer of the prostate gland - 2 patients, corrosion cancer - 3 patients, 1 patient in both liver cancer and Ewings sarcoma with metastases in the bone.
 Results:
 Indications for repeated surgery: errors in preoperative diagnosis 3 patients, postoperative infectious complication 6 patients, dislocation of the endoprosthesis 4 patients, continued growth of solitary metastasis after osteosynthesis 5 patients, aseptic instability after intramedullary osteosynthesis 14 patients, traumatic fracture of the leg of the endoprosthesis 1 patient.
 Conclusions:
 Repeated operations after surgical treatment of metastases in long bones and postoperative complications lead to errors in diagnosis and incorrect choice of surgical treatment method. To reduce the risk of repeated surgical interventions, a multidisciplinary approach is required with the development of surgical treatment tactics in consultation and the use of specialized scales of oncological prognosis.