Clinical results in surgical treatment of bone metastases in limbs: 126 cases report

WU Zong-ming; TANG Xian-zhong; YANG Qing-cheng

doi:10.3969/j.issn.2095-252X.2015.05.003

Abstract：Objective To retrospectively analyze the clinical results in surgical treatment of bone metastases in limbs in 126 cases.Methods The data of 126 patients with bone metastases in limbs who were admitted from January 2007 to December 2012 were retrospectively analyzed.There were 69 males and 57 females,whose average age was 65.8 years old ( range: 41-92 years ).Tumor-type prosthetic replacement was performed on 42 patients,prosthetic replacement on 14 patients,cement and interlocking intramedullary nailing on 38 patients,cement and plate fixation on 19 patients,tumor devitalization and plate fixation on 4 patients,limb shortening and plate fixation on 3 patients and external ifxation support on 6 patients.The patients' pain preoperatively and at 1 month after the surgery was evaluated by using visual analogue scale ( VAS ).The quality of life ( QOL ) preoperatively and at 3 months after the surgery was assessed by the short-form 36 (SF-36) questionnaire.Limb function at 3 months after the surgery was evaluated with the Musculoskeletal Tumor Society scale ( MSTS ).Results All the procedures were successfully performed,and no surgery-related death occurred.Postoperative complications were found in 11 cases,including acute respiratory distress syndrome ( ARDS ) in 1 case,stress ulcer ( SU ) in 2 cases,cerebral infarction ( CI ) in 2 cases,deep vein thrombosis ( DVT ) in 3 cases,acute renal failure ( ARF ) in 1 case,incision infection in 1 case and prosthesis dislocation in 2 cases.The symptoms were improved in all the patients after the corresponding treatment.All the patients were followed up,and the mean follow-up period was 32 months ( range: 3-60 months ).The postoperative survival time was 3-12 months in 45 cases,12-24 months in 32 cases,24-36 months in 26 cases and more than 3 years in 23 cases.The pain was signiifcantly improved after the surgery.The VAS score was 6.85±3.11 before the operation,which was reduced to 1.26±0.81 at 1 month after the operation (t=9.978,P＜0.001 ).The QOL was also signiifcantly improved.The mean QOL score was 38.30±13.05 before the operation,which was increased to 65.78±10.65 at 3 months after the operation (t=-18.550,P＜0.001 ).The mean postopertive MSTS score was 23.32±3.03 ( range: 17-30 ) (t=-1.450,P=0.016 ).Conclusions The pain can by effectivley relieved and the QOL and limb function can be signiifcantly inproved with the surgical treatment of bone metastases in limbs.