Related Experiment Video
Updated: May 11, 2025
Intra-Cardiac Injection of Human Prostate Cancer Cells to Create a Bone Metastasis Xenograft Mouse Model
Published on: November 4, 2022
Survival impact of pathological fractures in metastatic cancer: a comprehensive meta-analysis
José María Lamo-Espinosa1, Gonzalo Mariscal2, Jorge Gómez-Álvarez3
1Department of Orthopedic Surgery, IMED Colón, Valencia, Spain.
Introduction:
Metastatic patients face the risk of pathological fractures (PF). The incidence of PF varies among different cancer types, impacting patient survival and leading to substantial healthcare costs. However, conflicting findings regarding the survival impact of PF exist, and comprehensive meta-analyses addressing this issue are currently lacking. The aim of this study was to evaluate the survival of metastatic cancer patients with PF.
Methods:
This study adhered to PRISMA guidelines and employed the PICOS strategy for inclusion criteria. A comprehensive search was conducted across multiple databases. The primary focus was on survival outcomes. Statistical analysis employed Review Manager 5.4.1, calculating mean differences for continuous variables and generic inverse variances for hazard ratios. Heterogeneity was assessed using Chi2 and I2 tests.
Results:
A total of eight studies with 15,464 patients were included. Unadjusted hazard ratios (HRs) showed that PF increased the risk of mortality 1.45 (95% CI 1.22 to 1.73). Adjusted HRs confirmed significant increase in mortality risk for PF HR 1.31 (95% CI 1.08 to 1.57). The PF group had significant lower mean survival (MD -14.50, 95% CI -22.95 to -6.05). PF increased the risk of mortality in breast cancer (HR 1.52, 95% CI 1.32 to 1.76), prostate cancer (HR 1.38, 95% CI 1.16 to 1.64) and in leiomyosarcoma (HR 5.40, 95% CI 1.80 to 16.2).
Conclusion:
PF increases the mortality risk and reduces the mean survival of patients with metastatic cancer.
Related Concept Videos
02:30Metastasis
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...
01:21Cancer Survival Analysis
02:53Adaptive Mechanisms in Cancer Cells
Some of the advantages that cancer cells have on normal cells include - enhanced ability to divide without terminally differentiating, induce new blood vessel formation,...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...