The Treatment of Metastases in the Appendicular Skeleton

Capanna, R.; Campanacci, Domenico Andrea

doi:10.1302/0301-620x.83b4.0830471

Cited by 89 publications

(160 citation statements)

References 0 publications

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…Metastatic bone lesions are treated in order to control pain, to prevent pathological fractures and neurological impairment, and to maintain optimal quality of life for as long as possible [12]. The median survival time for lung cancer patients with synchronous bone metastasis is 5.5 months; the two-year survival rate is 3% [16].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical treatment of bone metastases in patients with lung cancer

Utzschneider

Wicherek

Weber

et al. 2010

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Lung cancer is the leading cause of cancer mortality. Bone metastases are a common complication in lung cancer. The therapeutic approach and the type of surgical treatment of these lesions have not been clearly defined. Outcome and prognosis of patients with bony metastases and a variety of surgical interventions were analysed retrospectively. In 58 patients we performed 62 surgeries. The most common locations of metastases were the spine (32 patients), the proximal femur (10) and the pelvis (11). Twenty-one patients had a singular and 20 had multiple osseous lesions; 17 showed additional visceral involvement. Nine patients had a local progression of their disease and 49 a systemic progression. Patients with local progression (n=9) had a better prognosis than the patients with systemic progression (p = 0.0083). Fracture (p = 0.0017) worsened prognosis, whereas the number of bone lesions or the presence of a visceral lesion did not. Patients with small lesions showed a better survival than patients with large lesions (p=0.02). Ten percent of the patients died within 30 days and 78% within one year after surgery. Fracture of bone due to metastatic lung cancer worsens the prognosis whereas the number of bone lesions, the presence of a visceral lesion and the surgical approach do not.

show abstract

Section: Discussionmentioning

confidence: 99%

“…There is still a lack of data regarding the role of surgery in the management of bone metastasis although the prognosis of the patients could be improved by applying multimodal therapies [10][11][12]. Since treatment of bone metastases is palliative, it must be weighed up to complications in terminally ill patients.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of bone metastases in patients with lung cancer

Utzschneider

Wicherek

Weber

et al. 2010

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Prophylactic fixation enhances survival, preserves function and ambulation, and reduces fracture incidence and pain. 1,[4][5][6][7][8][9][10][11][12][13] However, the ability to assess fracture risk and thus the need for prophylactic fixation are inexact. Current methods for assessing the degree of strength compromise produced by lytic lesions are based on retrospective studies of plain radiograph measurements and employ rules of thumb to determine if fixation is warranted.…”

Section: Introductionmentioning

confidence: 99%

Torsional strength estimates of femoral diaphyses with endosteal lytic lesions: Dual‐energy x‐ray absorptiometry study

Robertson

Beck

Chan

et al. 2007

Journal Orthopaedic Research

View full text Add to dashboard Cite

Pathologic fracture is a significant problem for individuals with metastatic bone disease. Current guidelines for prophylactic internal fixation are neither reliable nor easily applied. The purpose of this study was to validate dual-energy X-ray absorptiometry (DXA) as an accurate method for estimating torsional bone strength of diaphyseal bone with endosteal lytic lesions. Endosteal lesions of varying sizes were simulated in the diaphyses of 12 adult cadaveric femurs. Unaltered contralateral femurs served as matched controls. Machined lesions ranged from 3 to 6.5 cm in length, 1 to 3 cm in width, 15 to 48 cm 2 in elliptical area, with 10% to 100% removal of the cortical thickness. Morphology and density data obtained from DXA images were used to estimate torsional strength. All femora were mechanically tested to failure in torsion. Physically measured torsional strength was not significantly correlated to lesion elliptical area (r ¼ 0.542, p > 0.05) or percentage cortical thickness removed (r ¼ 0.257, p > 0.05). Measured torsional strength was significantly correlated to DXA-based torsional strength estimates (r ¼ 0.855, p < 0.01). Lesion size alone did not correlate with the strength of bones with simulated endosteal lytic lesions. In contrast, calculations based on DXA (morphology, density) did correlate with torsional strength. This is the first step in the development of a DXA-based tool for objectively estimating bone strength in the presence of endosteal lytic lesions. ß

show abstract

“…Bone metastatic disease adversely affects quality of life and survival [3,22], and many patients with bone metastases undergo surgery to treat or prevent a pathological fracture [3,5,22]. Blood loss during operative treatment of metastatic fractures can be substantial and blood transfusions frequently are administered [25].…”

Section: Introductionmentioning

confidence: 99%

Are Allogeneic Blood Transfusions Associated With Decreased Survival After Surgery for Long-bone Metastatic Fractures?

Janssen

Braun

Ready

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Previous studies have shown that perioperative blood transfusion increases cancer recurrence and decreases patient survival after resection of primary malignancies. The question arises whether this association also exists in patients with already disseminated disease undergoing surgery for metastatic long-bone fractures. Purposes We sought to determine whether perioperative allogeneic blood transfusion is associated with decreased survival after operative treatment of long-bone metastatic fractures after accounting for clinical, laboratory, and treatment factors. Secondarily, we aimed to identify potential factors that are associated with decreased survival. Methods We included 789 patients in our retrospective study who underwent surgery at two institutions for a pathologic or impending metastatic long-bone fracture. We used multivariable Cox proportional hazards regression model analysis to assess the relationship of perioperative allogeneic blood transfusion with survival, and accounted for patient age, sex, comorbidities, BMI, tumor type, fracture type and location, presence of other bone and visceral metastases, previous radiotherapy and systemic therapy, preoperative embolization, preoperative hemoglobin level, treatment type, anesthesia time, blood loss, duration of hospital admission, year of surgery, and hospital. Results Considering transfusion as an ''exposure,'' and comparing patients who received transfusions with those who did not, we found that blood transfusion was not associated with decreased survival after accounting for all explanatory variables (hazard ratio [HR] 1.06; 95% CI, 0.87-1.30; p = 0.57). Evaluating transfusion in terms of dose-response, we found that patients who received more transfusions had lower survival compared with those who had fewer transfusions after accounting for all explanatory variables (HR per unit of blood transfused, 1.07; 95% CI, 1.02-1.12; p = 0.005). We found that age (HR, 1.02; 95%

show abstract

The Treatment of Metastases in the Appendicular Skeleton

Cited by 89 publications

References 0 publications

Surgical treatment of bone metastases in patients with lung cancer

Surgical treatment of bone metastases in patients with lung cancer

Torsional strength estimates of femoral diaphyses with endosteal lytic lesions: Dual‐energy x‐ray absorptiometry study

Are Allogeneic Blood Transfusions Associated With Decreased Survival After Surgery for Long-bone Metastatic Fractures?

Contact Info

Product

Resources

About