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31 October 2012

Short-term outcomes of en bloc resection of solitary bone metastases in limbs

Qingcheng YangABE, Bizeng ZhaoAE, Zhichang ZhangC, Yang DongD, Yao PanACF, Xinhui DuDE

DOI: 10.12659/MSM.883542

Med Sci Monit 2012; 18(11): CR648-655

Abstract

Background: To evaluate the pain, quality of life (QOL), and limb function of patients after en bloc resection of solitary metastatic bone cancer in the limbs.
Material/Methods: A total of 27 patients with solitary metastatic bone cancer in the limbs were recruited. All these patients underwent limb-salvage surgery with en bloc resection of the metastatic tumor. Pain and QOL were evaluated before and after surgery. Pain was assessed with a 10-point scale before and 1 month after surgery. The QOL was evaluated with the SF-30 scale before and 3 months after surgery. Limb function was evaluated with the Musculoskeletal Tumor Society scale (MSTS) 3 months after surgery. Follow-up was performed for 6~31 months (mean: 16.15±7.47 months).
Results: All procedures were successfully performed. Post-operative complications were found in 6 patients, including incision infection, prosthesis dislocation, deep vein thrombosis, and pulmonary infection. The pain score before and 1 month after surgery was 6.85±3.11 and 1.26±0.81, respectively, indicating obvious improvement (t=9.978, P<0.001). The QOL score before and 3 months after surgery was 38.30±13.05 and 65.78±10.65, respectively, indicating pronounced improvement (t=–18.550, P<0.001). The mean post-operative MSTS score was 23±3 (range: 17–30) (t=–1.450, P=0.016). No local recurrence was observed in any patient during the follow-up.
Conclusions: Limb salvage surgery with wide or marginal resection for solitary metastatic bone cancer may significantly improve the pain, QOL, and limb function, but there is no difference in local control between wide and marginal resection.

Keywords: Postoperative Complications - etiology, Neoplasm Recurrence, Local - pathology, Limb Salvage - methods, Femoral Fractures - pathology, Extremities - surgery, Disease-Free Survival, Bone Neoplasms - surgery, Quality of Life, Time Factors

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750