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Femoral metastatic pathological fractures, impending and actual fractures - A patient survival study.
- Source :
-
Surgical oncology [Surg Oncol] 2023 Dec; Vol. 51, pp. 102014. Date of Electronic Publication: 2023 Nov 03. - Publication Year :
- 2023
-
Abstract
- Introduction: The skeleton is a common site for metastases. Prostate, breast, lung, renal and thyroid carcinomas account for 80 % of the original cancers, with the femur being the most affected long bone. With improved oncological treatments, prolonged patient survival leads to an increased prevalence of osseous metastases. This study examines the impact of preventive surgery for impending femoral pathological fracture (IFF), versus treatment of pathological femur fracture (PFF) on patient mortality and morbidity.<br />Methods: Retrospective cohort of 174 patients undergoing surgery due to femoral metastases (2004-2015). Eighty-two patients were with PFF, and 92 were with IFF based on the Mirels' score. The followed-up period was until 2016. Demographic data, oncological, pathological, radiation, surgical reports, outpatient clinical records, and imaging studies were examined. Exclusion criteria included primary tumours and Multiple Myeloma.<br />Results: The mean age was 64.8 ± 13.3 and 60.2 ± 11.9 years (p = 0.02) in the PFF and the IFF cohorts, with 62.1 % women and 57 % men. The breast was the most common source of femoral metastases. The average Mirels' score was 10 ± 1.2. There was an association between tumour origin and survival. Carcinoma of the lung had the worst survival, while the prostate had the most prolonged survival. Survival rates differed between IFF and PFF (p = 0.03). Postoperative complications occurred in 26 % of the patient, with no difference between IFF & PFF.<br />Conclusion: Breast and lung are the most common tumours to metastasize the femur. Our study revalidates that pathological femoral fractures impede patient survival compared to impending fractures and should undergo preventive surgery. Postoperative complications do not differ between IFF and PFF but remain relatively high. Overall, patients with proximal femoral metastatic disease survive longer than previously published, probably due to improved treatment modalities.<br />Competing Interests: Declaration of competing interest All authors declare that there is no conflict of interest.<br /> (Copyright © 2023 Elsevier Ltd. All rights reserved.)
- Subjects :
- Male
Humans
Female
Middle Aged
Aged
Retrospective Studies
Femur pathology
Postoperative Complications epidemiology
Fractures, Spontaneous etiology
Fractures, Spontaneous surgery
Fractures, Spontaneous pathology
Femoral Fractures surgery
Femoral Fractures etiology
Femoral Fractures pathology
Bone Neoplasms surgery
Bone Neoplasms secondary
Subjects
Details
- Language :
- English
- ISSN :
- 1879-3320
- Volume :
- 51
- Database :
- MEDLINE
- Journal :
- Surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 37944334
- Full Text :
- https://doi.org/10.1016/j.suronc.2023.102014