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Solitary versus multiple bone metastases in the appendicular skeleton
Thea H Ladegaard1, Michala S Sørensen1, Michael M Petersen1
1Musculoskeletal Tumour section, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
The Bone & Joint Journal
|October 31, 2023
Summary
Surgical treatment for solitary bone metastases in the appendicular skeleton offers better survival than for multiple metastases. Complete resection (R0 surgery) for solitary metastases significantly improves patient survival rates.
Area of Science:
- Orthopedic Oncology
- Surgical Oncology
- Cancer Metastasis Research
Background:
- Appendicular skeleton metastases significantly impact patient prognosis.
- Distinguishing survival outcomes between solitary and multiple bone metastases is crucial for treatment planning.
Purpose of the Study:
- To compare survival rates for patients undergoing surgery for solitary versus multiple appendicular skeletal metastases.
- To investigate the impact of complete (R0) versus incomplete (R1/R2) resection on survival for solitary appendicular skeletal metastases.
Main Methods:
- Retrospective analysis of a population-based cohort of adult patients surgically treated for appendicular skeletal metastases (2014-2019).
- Kaplan-Meier survival analysis with log-rank testing was employed.
- Exclusion of patients with unknown metastasis status or resection margins.
Main Results:
- One-year survival was 47% for solitary and 34% for multiple bone metastases (p < 0.001).
- One-year survival for solitary metastases was 64% without visceral metastases and 23% with visceral metastases (p < 0.001).
- One-year survival was 75% for R0 resection and 42% for R1/R2 resection in solitary metastases (p < 0.001).
Conclusions:
- Surgical management of solitary appendicular skeletal metastases is associated with superior survival compared to multiple metastases.
- Complete resection (R0) of solitary appendicular skeletal metastases may enhance patient survival outcomes.
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