Surgical Treatment of Metastatic Bone Disease in the Appendicular Skeleton: A Population-Based Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Variables
2.3. Statistical Analysis
3. Results
3.1. Incidence of aBM
3.2. Patient Demographics and Referral Patterns
3.3. Biopsies
3.4. Surveillance Scan
3.5. Time Till Surgery
3.6. Survival
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | (n/Missing) | All Patients | MTC | SSC | p-Value |
---|---|---|---|---|---|
Age at Surgery (years) | (493/0) | <0.001 1 | |||
Mean (range) | 70 (32–99) | 67 (32–96) | 74 (43–99) | ||
Sex | (493/0) | 0.2 2 | |||
Female | 254 (52%) | 140 (49%) | 114 (55%) | ||
Male | 239 (48%) | 145 (51%) | 94 (45%) | ||
Primary Cancer | (493/0) | 0.2 2 | |||
Fast Growth | 171 (35%) | 93 (33%) | 78 (38%) | ||
Moderate Growth | 153 (31%) | 96 (34%) | 57 (27%) | ||
Slow Growth | 169 (34%) | 96 (34%) | 73 (35%) | ||
Location | (493/0) | 0.010 2 | |||
Lower Extremity | 414 (84%) | 229 (80%) | 185 (89%) | ||
Upper Extremity | 79 (16%) | 56 (20%) | 23 (11%) | ||
Fracture | (493/0) | <0.001 2 | |||
Complete | 378 (77%) | 187 (66%) | 191 (92%) | ||
Impending | 115 (23%) | 98 (34%) | 17 (8.2%) | ||
Type of Implant | (493/0) | <0.001 2 | |||
Endoprosthesis | 296 (60%) | 242 (85%) | 54 (26%) | ||
No Implant | 23 (4.7%) | 17 (6.0%) | 6 (2.9%) | ||
Osteosynthesis | 174 (35%) | 26 (9.1%) | 148 (71%) | ||
Karnofsky Score | (493/0) | <0.001 2 | |||
<70 | 165 (33%) | 76 (27%) | 89 (43%) | ||
>= 70 | 328 (67%) | 209 (73%) | 119 (57%) | ||
ASA Group | (485/8) | 0.074 2 | |||
Group 1 + 2 | 162 (33%) | 104 (37%) | 58 (29%) | ||
Group 3 + 4 | 323 (67%) | 180 (63%) | 143 (71%) | ||
Bone Metastases | (474/19) | <0.001 2 | |||
Solitary Lesion | 118 (25%) | 89 (31%) | 29 (15%) | ||
Multiple Lesions | 356 (75%) | 195 (69%) | 161 (85%) | ||
Visceral Metastases | (451/42) | 0.001 2 | |||
No | 225 (50%) | 152 (56%) | 73 (41%) | ||
Yes | 226 (50%) | 119 (44%) | 107 (59%) | ||
Days From Diagnosis to Surgery | (493/0) | 0.2 1 | |||
Median Days (IQR) | 588 (70,2003) | 613 (97,2003) | 450 (46,2003) | ||
Irradiation of Lesion Prior to Surgery | (493/0) | 0.063 2 | |||
No | 411 (83%) | 230 (81%) | 181 (87%) | ||
Yes | 82 (17%) | 55 (19%) | 27 (13%) | ||
Systemic Treatment | (493/0) | 0.08 2 | |||
No | 238 (48%) | 128 (45%) | 110 (53%) | ||
Yes | 255 (52%) | 157 (55%) | 98 (47%) | ||
Debut of Cancer | (493/0) | 0.6 2 | |||
No | 394 (80%) | 230 (81%) | 164 (79%) | ||
Yes | 99 (20%) | 55 (19%) | 44 (21%) | ||
Debut of Cancer Relapse | (394/99) | 0.041 2 | |||
No | 328 (83%) | 184 (80%) | 144 (88%) | ||
Yes | 66 (17%) | 46 (20%) | 20 (12%) |
Treatment Center | ||||
---|---|---|---|---|
Primary Cancer | (n) | All Patients | MTC | SSC |
Slow growth | (169) | |||
Breast | 100 (20%) | 56 (20%) | 44 (21%) | |
Myeloma | 51 (10%) | 31 (11%) | 20 (9.6%) | |
Lymphoma | 13 (2.6%) | 5 (1.8%) | 8 (3.8%) | |
Thyroid | 5 (1.0%) | 4 (1.4%) | 1 (0.5%) | |
Moderate growth | (150) | |||
Prostate | 80 (16%) | 48 (17%) | 32 (15%) | |
Kidney | 59 (12%) | 40 (14%) | 19 (9.1%) | |
Sarcoma | 7 (1.4%) | 5 (1.8%) | 2 (1.0%) | |
Other gynecological cancer | 4 (0.8%) | 2 (0.7%) | 2 (1.0%) | |
Fast Growth | (174) | |||
Lung | 100 (20%) | 52 (18%) | 48 (23%) | |
Colorectal | 12 (2.4%) | 7 (2.5%) | 5 (2.4%) | |
Malignant Melanoma | 9 (1.8%) | 7 (2.5%) | 2 (1.0%) | |
Bladder | 9 (1.8%) | 6 (2.1%) | 3 (1.4%) | |
Head and neck | 6 (1.2%) | 4 (1.4%) | 2 (1.0%) | |
Pancreatic | 5 (1.0%) | 2 (0.7%) | 3 (1.4%) | |
Hepatocellular | 3 (0.6%) | 2 (0.7%) | 1 (0.5%) | |
Gastrointestinal | 2 (0.4%) | 1 (0.4%) | 1 (0.5%) | |
Gallbladder | 2 (0.4%) | 1 (0.4%) | 0 (0%) | |
Ventricular | 1 (0.2%) | 2 (0.7%) | 0 (0%) | |
Unknown origin | 22 (4.5%) | 9 (3.2%) | 13 (6.2%) | |
Others | 3 (0.6%) | 1 (0.4%) | 2 (1.0%) |
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Ladegaard, T.H.; Sørensen, C.L.; Nielsen, R.; Troelsen, A.; Al-Mousawi, D.A.A.; Bielefeldt, R.; Petersen, M.M.; Sørensen, M.S. Surgical Treatment of Metastatic Bone Disease in the Appendicular Skeleton: A Population-Based Study. Cancers 2022, 14, 1258. https://doi.org/10.3390/cancers14051258
Ladegaard TH, Sørensen CL, Nielsen R, Troelsen A, Al-Mousawi DAA, Bielefeldt R, Petersen MM, Sørensen MS. Surgical Treatment of Metastatic Bone Disease in the Appendicular Skeleton: A Population-Based Study. Cancers. 2022; 14(5):1258. https://doi.org/10.3390/cancers14051258
Chicago/Turabian StyleLadegaard, Thea Hovgaard, Celine Lykke Sørensen, Rasmus Nielsen, Anders Troelsen, Dhergam Ahmed Ali Al-Mousawi, Rikke Bielefeldt, Michael Mørk Petersen, and Michala Skovlund Sørensen. 2022. "Surgical Treatment of Metastatic Bone Disease in the Appendicular Skeleton: A Population-Based Study" Cancers 14, no. 5: 1258. https://doi.org/10.3390/cancers14051258