Abstract 1891P
Background
The bone represents the third most frequent site of metastasis1. It’s usually associated with high morbidity, decrease quality of life and short-term prognosis2. Therefore, requires a multidisciplinary approach3. We review the surgical treatment experience of bone metastasis in our center.
Methods
Retrospective analysis of patients treated surgically in our institution due to bone metastases between August 2004 and October 2019. Main outcome measures are demographics, presentation, management, follow up and complications.
Results
We analyzed 114 patients, 50% female and male, median age 67 years (55-79), 43% greater than 70. Primary tumor site was lung (34.2%), breast (22.8%), hematological cancers (9.6%), prostate (7.9%) and thyroid (2.6%). Metastasis locations were 62.3% in femur and 33.3% in humerus. 71% had PS 0-1, 20.2% were oligometastatic and 56% had visceral metastasis. 31.6% were prophylactic surgery, 69.4% due to fracture (83.3% pathological, 9% traumatic, 7.7% mix component). 36% received perioperative radiotherapy and 34.2% bone-targeted agents. Intervention was mainly endomedullary nailing (69.3%) and oncological surgery (26.3%), with 20% of early complications and 7.8% of late ones. 47 patients (41.2%) had a skeletal-related event: pain (38.3%), fractures (34%), hypercalcemia (17%), and spinal compression (10.7%). Median overall survival (OS) and progression free survival (PFS) according to type of tumor is: Lung 9.3 and 8.2 months, respectively. Prostate 28 and 26.3 months. Hematological cancers 22.3 and 17.9 months. Breast 50.8 and 27.4 months. Thyroid 98.3 and 71.2 months. Comparing prophylactic vs emergency surgery, median OS is 25.6 vs 18.5 months (p-value 0.166), and median PFS 21.8 vs 19.5 months (p-value 0.677). Complication were lower in the first group (13.9% early and 5.6% late complications). The subanalysis by type of tumor shows a significant difference in OS in lung cancer (17.7 vs 4.7, p-value 0.002).
Conclusions
Surgical treatment of bone metastases is an emerging treatment modality, being an effective and safe alternative. Prophylactic surgery, if possible, should be performed since it is related to lower complication rates, more radical attitude and better prognosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.