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Related Concept Videos

Metastasis02:30

Metastasis

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Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
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Updated: Jun 24, 2025

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
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Treatment algorithm for metastatic malignancies in the lower extremities.

Kazuhiko Hashimoto1, Shunji Nishimura1, Tomohiko Ito1

  • 1Department of Orthopedic Surgery, Kindai University Hospital, Osakasayama, Osaka 589-8511, Japan.

Molecular and Clinical Oncology
|June 14, 2024
PubMed
Summary

This study analyzed 30 patients with cancer-related femur fractures, finding that impending fractures had shorter operative times and less blood loss than pathological fractures. This research enhances treatment strategies for metastatic bone disease.

Keywords:
bone tumorimpending fracturesmalignancypathological fracturessurgical treatment

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Area of Science:

  • Orthopedic Surgery
  • Oncology
  • Pathology

Background:

  • Proximal femoral metastases are common in cancer patients, often leading to lower extremity fractures.
  • Effective surgical treatment strategies are crucial for managing metastatic malignancies and improving patient outcomes.

Purpose of the Study:

  • To analyze the clinical characteristics of patients undergoing surgical treatment for pathological or impending proximal femoral fractures.
  • To enhance treatment strategies for metastatic malignancies affecting the femur.
  • To compare outcomes between impending and pathological fractures, and different surgical modalities.

Main Methods:

  • Retrospective analysis of 30 patients treated for impending or pathological femur fractures at Kindai University Hospital.
  • Data collected included patient demographics, fracture site, primary malignancy, Eastern Cooperative Oncology Group performance status (ECOG-PS), treatment modalities, operative details (time, blood loss), postoperative complications, Musculoskeletal Tumor Society (MSTS) scores, and survival rates.
  • Statistical comparisons were made between fracture types and surgical procedures.

Main Results:

  • The median age of patients was 70.5 years, with common primary sites including lung, breast, and multiple myeloma.
  • A significant negative correlation (R=-0.63) was observed between MSTS scores and pre-fracture ECOG-PS.
  • Impending fractures demonstrated significantly shorter operative times and lower blood loss compared to pathological fractures.

Conclusions:

  • The study's findings suggest an efficient treatment algorithm for malignant bone tumors of the lower extremity.
  • Optimizing treatment strategies can improve patient care and outcomes in orthopedic oncology.
  • Understanding the differences between impending and pathological fractures aids in surgical planning and resource allocation.