Early Complications in the Orthopedic Treatment of Bone Metastases

Abstract

Objective: To assess the early complications in the orthopedic treatment of metastatic bone lesions and the factors associated with these complications. Method: There were assessed, retrospectively, 64 patients that underwent surgical treatment for bone metastases, analyzing the complications that occurred in the pre-operative and early post- operative period and associating them with the tumor origin, type of procedure done, the need of blood reposition before the surgery, the need of new surgical procedures and the mortality due to the complications. Results: Early complications in the treatment were observed in 17 (26.6%) patients, of which six (35.2%) ended up dying due to these complications. Regarding the type, 15 (23.8%) cases were due to surgical complications, four (6.3%) clinical and three (4.7%) patients showed clinical and surgical complications. There was no significant difference in the frequency of complications or mortality when assessed the type of reconstruction or affected region. The tumors with a renal origin needed more blood reposition and showed a bigger frequency of complications. Conclusion: The complications occurred in 26.6%. The complications are not related to the kind of treatment performed or to the region affected. The renal origin tumors showed a higher risk of hemorrhage.

Profile of Surgically-treated Metastatic Extremity Bone Tumours at a University Hospital in Hong Kong

“…The basic demographic data of patients in this study with respect to age parameters and sex distribution is in agreement with reports elsewhere of patients affected by bone metastases in general. 1,2,8,10 The slight preponderance of females over the males as well as the mean age of the patient population observed in our study is corroborated by these other reports. Such primary carcinomas as prostate, breast, kidney, lung, and thyroid cancers have been associated with high risks of metastatic bone diseases and are known to be responsible for 80% of all the metastases to the bone.…”

“…In the study by Yehuda et al, 10 the femur was the most common site of renal cell carcinoma metastasis requiring surgery. Also the work by Teixeira et al 1 showed that the femur accounted for 79.7% of metastatic sites requiring surgery in their patients. In both series, the proximal femur (hip) was the most common site of metastasis needing surgery.…”

“…As prolonged survival is recorded in more patients with primary malignancies following advances in oncological and surgical treatments, it is expected that the prevalence of metastatic bone diseases would also be on the increase. 1,8 This has been postulated to imply that the burden of the primary malignant diseases with the potentials of bone metastases would assume a chronic proportion. 8 Therefore, there is bound to be an increase in the need for stabilisation of impending and actual pathologic fractures, restoration of mobility and gait, as a means of contributing to the reduction in the overall morbidity during the survival period of cancer patients.…”

“…Opinion is divided in literature with respect to whether or not the skeleton is the most common site of metastatic disease ahead of the lung and the liver. 1e3 Whereas Teixeira et al 1 hold that bone is the third most common site for metastatic disease, after lung and liver, Utzschneider et al 2 and Coleman 3 have stated that the skeleton is the most common site affected by metastatic cancer. Metastatic lesions are the most common malignant tumours affecting the skeleton, representing a significant burden on the healthcare system in a place like the United States, where more than 280,000 adults had metastatic bone disease as at 2008.…”

Functional assessment of endoprosthesis in the treatment of bone tumors

“…With advances in protocols and treatment of cancer patients and consequent increase in survival, the number of patients with bone metastases has increased, as well as the incidence of complications 1, 2, 3, 4. One of the complications often found in these patients are pathological fractures, especially in the lower limbs, which invariably affect the meta-epiphyseal region of the bone and requires joint reconstruction.…”