Surgical Treatment and Prognostic Factor for Metastatic Bone Tumor.
10.4055/jkoa.2008.43.4.438
- Author:
Jeung Il KIM
1
;
Chong Il YOO
;
Jeung Tak SUH
;
Kuen Tak SUH
;
Hui Taek KIM
;
Nam Hoon MOON
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Pusan National University, Pusan, Korea. osteokim@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Metastatic bone tumor;
Surgical treatment;
Prognostic factor
- MeSH:
Extremities;
Fractures, Spontaneous;
Humans;
Life Expectancy;
Neoplasm Metastasis;
Proportional Hazards Models;
Retrospective Studies;
Spine
- From:The Journal of the Korean Orthopaedic Association
2008;43(4):438-444
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In this retrospective study, we tried to find out potential prognostic factors that can be used to determine the optimal treatment for some conditions that are indicated for surgery like pathological fractures or epidural compression. MATERIALS AND METHODS: Between 1985 and 2003 we treated 78 patients with skeletal metastases. A multivariable analysis was conducted using the Cox proportional hazard model. The rates of survival were calculated by the Kaplan-Meier method. RESULTS: We identified four significant prognostic factors for survival: the site of the primary lesion, the presence of visceral or cerebral metastases, any previous chemotherapy and multiple skeletal metastases. With these factors, we could divide the patients into two prognostic groups: the good prognostic group satisfies more than two of the four significant factors and the poor prognostic group doesn't. For the good prognostic group, the average rates of survival at 6 months and a year were 95% and 28%, respectively, and those for the poor prognostic group were 28% (6 mo) and 13% (1 yr), respectively. CONCLUSION: Each patient's life expectancy should be considered when we decide the surgical method for treating metastatic bone tumor. Patients with a very short life expectancy should probably be treated with a less invasive method but patients with a long life expectancy require aggressive surgery. If the life expectancy is estimated to be at least more than 2 month and 3-6 months for bony metastases to the extremity and spine respectively, then an aggressive surgical method should be chosen. With these practical prognostic factors, the life expectancy may be predicted more accurately and so the optimal surgical treatment can be selected more appropriately.
