Factors associated with local recurrence after surgery for bone metastasis to the extremities

被引:13
作者
Krishnan, Chandra Kumar [1 ,2 ]
Kim, Han-Soo [1 ]
Yun, Ji Yeon [1 ]
Cho, Hwan Seong [3 ]
Park, Jong Woong [1 ]
Han, Ilkyu [1 ]
机构
[1] Seoul Natl Univ Hosp, Dept Orthopaed Surg, 101 Daehak Ro, Seoul 03080, South Korea
[2] Canc Inst WIA, Dept Surg Oncol, Madras, Tamil Nadu, India
[3] Seoul Natl Univ, Dept Orthoped Surg, Bundang Hosp, Seongnam, South Korea
关键词
bones of lower extremity; bone neoplasms; bones of upper extremity; neoplasm metastasis; RENAL-CELL CARCINOMA; SKELETAL METASTASES; DISEASE; STABILIZATION; MANAGEMENT; FRACTURES; RESECTION; SURVIVAL; KIDNEY; CANCER;
D O I
10.1002/jso.24880
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and ObjectivesWith increasing life expectancy of patients with bone metastasis, durable surgical stabilization of bone metastasis is necessary. Local recurrence (LR) can compromise surgical stabilization and necessitate retreatment. We analyzed LR rate and factors associated with LR in patients undergoing surgery for bone metastasis. MethodsPatients (n=301) who underwent surgery for bone metastasis to the extremities were reviewed. Possible factors that might be associated with LR were investigated. ResultsLR rate was 16% (49/301). Surgical margin was associated with LR, as patients with en-bloc resection had significantly less LR than patients who underwent curettage (5/66 vs 44/235, P=0.03). Prostate cancer had lowest rate (0%) of LR and colon cancer had highest rate (31%). Interval from surgery to LR differed among primary cancer types (4.53.9 months [lung cancer], vs 12.3 +/- 12.9 months [other cancers], P=0.041). In multivariate analysis, en-bloc surgical margins (HR=0.372, P=0.036) and primary cancers of breast or prostate (HR=0.391, P=0.049) were independent factors associated with longer LR-free survival. ConclusionsLR after surgery for bone metastasis to extremities is affected by surgical margin and primary cancer type. These factors, along with expected patient survival, need to be considered when planning surgery for bone metastasis to extremities.
引用
收藏
页码:797 / 804
页数:8
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