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3 . 2022

Surgical treatment of patients with bone metastases

Abstract

Metastatic bone disease is one of the important problems of modern oncology. In most patients with metastatic lesions of the skeleton, surgical interventions are aimed at palliative treatment, however, in some cases with solitary metastatic lesions, radical resections with plastic and reconstructive surgery can be considered, and life expectancy prognosis associated with histological structure of the malignant tumor is the main and decisive factor in determining the appropriate type of surgical treatment.

Aim. Surgical outcome assessment of patients with bone metastases.

Material and methods. Treatment analysis of 715 patients who underwent surgery for metastatic bone lesions is presented. Most often, surgical intervention was performed on the spine – 48.5%, long bones metastases – 35% of operations, pelvic bones metastases – 11% of interventions, chest wall metastases – 5.5% of operations.

Results. Median survival was 14 months. Quality of life improvement according to the Karnofski and EGOG scale after surgery was noted in the majority of patients [633 (88.5%)]. Postoperative complications were detected in 36 (5%) patients, most of them were infectious, 21 patient (3%). Tactical errors in the choice of extent of surgery were found in 49 (7%) patients and were associated with an incorrect assessment of life expectancy in oncologic patients.

Conclusion. Active surgical tactics in case of skeletal metastases along with a favorable oncological prognosis can improve patient’s life quality and, in case of solitary lesions, prolong it. New program development for the treatment strategy based on the patient’s life expectancy prognosis and algorithms of surgical treatment will reduce an error probability in choosing the method of onco-orthopedic treatment and increase the effectiveness of it.

Keywords:surgical treatment; chest wall metastases; oncological prognosis

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Bukharov A.V., Derzhavin V.A., Yadrina A.V., Erin E.A., Elkhov D.O., Aliev M.D., Kaprin A.D. Surgical treatment of patients with bone metastases. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (3): 100–7. DOI: https://doi.org/10.33029/2308-1198-2022-10-3-100-107  (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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