Massive endoprosthetic replacement for bone metastases resulting from renal cell carcinoma: Factors influencing patient survival

Hwang, Narae; Nandra, Rajpal; Grimer, R. J.; Carter, S.R.; Tillman, R. M.; Abudu, A.; Jeys, Lee

doi:10.1016/j.ejso.2013.08.001

Cited by 34 publications

(23 citation statements)

References 12 publications

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“…Systemic therapies (e.g., chemotherapy, hormonal therapy, or targeted therapy) are known to improve overall survival (OS) in certain patients with distant metastases . The surgical management of isolated BM is also feasible and improves survival outcomes . Reports indicate that radiotherapy (RT) dose escalation improves local disease control in patients with BM .…”

Section: Introductionmentioning

confidence: 99%

Dose‐escalated radiation therapy is associated with better overall survival in patients with bone metastases from solid tumors: a propensity score‐matched study

et al. 2017

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We aimed to compare the overall survival (OS) of patients with bone metastases (BM) from solid tumors after standard‐dose radiotherapy ([RT]; 30 Gy administered in 10 fractions; EQD2Gy = 32.5 Gy) and dose‐escalated RT (EQD2Gy > 32.5 Gy). We retrospectively reviewed the clinical charts of 1795 patients (median age, 62.3 years; age range, 18–96 years) with BM from solid tumors who were referred for RT to our institute between 2000 and 2013. These patients were assigned to the standard‐dose (n = 1125; 63%) and dose‐escalated (n = 670; 37%) RT groups. OS, estimated as the duration between the first RT session and death, served as the main outcome measure. The dose‐escalated RT group had a significantly better OS than the standard‐dose RT group (P = 0.000). After allowing potential confounders in multivariate analysis, the RT dose retained its independent association with OS (hazard ratio [HR], 0.837; 95% confidence interval [CI], 0.753–0.929, P = 0.001). After propensity score matching of the baseline characteristics of both groups, RT dose retained its independent association with OS (HR, 0.887; 95% CI, 0.737–0.951; P = 0.011) on multivariate analysis. Dose‐escalated RT exerted more favorable effects on OS in patients with non‐lung cancer, those without multiple metastases, those without symptoms, and those with favorable prognosis. Dose‐escalated RT was significantly associated with better OS in patients with BM from solid malignancies, particularly among those with non‐lung cancer, those without multiple metastases, those without symptoms, and those with favorable prognosis.

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Section: Introductionmentioning

confidence: 99%

Dose‐escalated radiation therapy is associated with better overall survival in patients with bone metastases from solid tumors: a propensity score‐matched study

et al. 2017

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“…For patients expected to live greater than 6 months, the literature supports curettage of the lesion with cemented hemiarthroplasty [41][42][43]. Those patients demonstrating a Arthroplasty for Proximal Femur Fracture http://dx.doi.org/10.5772/intechopen.77053 radioresistant tumour may necessitate en bloc excision and proximal femoral replacement [44]. Intramedullary fixation should be utilised in those with a life expectancy less than 6 months as it has been demonstrated to provide reliable fracture fixation up to 12 months post-procedure [45,46].…”

Section: Thr For Pathological or Impending Fracturementioning

confidence: 99%

Arthroplasty for Proximal Femur Fracture

Curtin¹,

Pomeroy²,

Broderick³

2018

Total Hip Replacement - An Overview

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With an increasing global incidence of hip fractures, designing appropriate treatment strategies for hip fractures is fundamentally important to healthcare professionals, policymakers, and payers of healthcare services. We will evaluate the role of total hip replacement (THR) in the setting of trauma for the acute treatment of hip fractures. In this chapter, we will compare hemiarthroplasty and total hip replacement in the acute setting while also examining the role of arthroplasty in the setting of failed internal fixation, as well as in pathologic fractures. We will describe the pearls and pitfalls of surgical technique in these scenarios, highlighted with case examples.

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“…Szelektálatlan, azaz mindenfajta tumor csontmetasztázi-sát magába foglaló közlemények egyéves túlélése 39-54% között mozgott [2,8,[25][26][27], ami alacsonyabbnak bizonyult az emlő-vagy veseráknál észlelteknél [11, 12, 14, 18-20, 28, 29], de nem meglepő módon lényegesen meghaladta a tüdőrákok egyéves túlélési eredményeit [20,30,31]. Az emlő-és veserákok 45-58%-os egyéves biztató túlélési eredményei azonban az első öt év végére már mindössze 8-20%-ra csökkentek [11,14,19,28]. Legjobb ötéves túlélést szoliter csontáttétek radikális sebészi eltávolításával értek el [12,14].…”

Section: Prognosztikai Faktorok éS Diagnosztikai Algoritmus Jelentőséunclassified

Paradigmaváltás a csontmetasztázisok sebészetében. I. Végtagi és medencelokalizációjú áttétek

et al. 2017

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Rákregiszterek statisztikái szerint míg a rák incidenciája az elmúlt évtizedben is folyamatosan nőtt, az újabb hatásos multimodalitású kezelések eredményeképpen a mortalitása alig emelkedett. Összefoglaló közleményünk célja annak bemutatása, hogy újabb irodalmi adatok alapján hogyan változott a csontmetasztázisos betegek túlélése, milyen prognosztikai faktorok befolyásolják a betegek esélyeit. A jobb eredmények aktívabb sebészi beavatkozást eredményeztek a végtagi és a csigolyaáttétek kezelésében egyaránt. Bemutatjuk a sebészi rekonstrukciós eljárások algoritmusát, tár-gyaljuk a különböző megoldások előnyeit, hátrányait, szövődményeit. Megállapítható, hogy a patológiás/fenyegető patológiás törésektől eltekintve nem a sebészi az első körben választandó eljárás, és ez is rendszerint palliatív céllal történik. Célja, hogy a beteg fájdalmait csökkentsük, mobilitását visszaadjuk, életminőségét javítsuk, lehetőleg olyan kevéssé megterhelő eljárásokkal (minimálisan invazív), amelyek gyors rehabilitációt tesznek lehetővé, és a beteg élete végéig kitartanak. Optimális esetben, körülbelül 10-15%-ban, lehetőség van a metasztázis kuratív eltávolítására is, biztatóak a jobb túlélési eredmények. Orv Hetil. 2017; 158(40): 1563-1569.Kulcsszavak: csontmetasztázis, kivizsgálási algoritmus, prognosztikai faktorok, végtag, medence, metasztázis-sebészet Change of paradigm in the surgical treatment of metastatic diseases of bone Part I. Bony metastases of the extremities and pelvisAccording to the statistical data of tumor registries the incidence of cancer has increased in the last decade, however the mortality shows only a slight change due to the new and effective multimodal treatments. The aim of our overview article is to present the changes in the survival of the metastatic patients, and to demonstrate which factors influence their prognosis. The improvement of survival resulted in a more active surgical role both in metastases of the bone of the extremities and the pelvis. We present a diagnostic flow chart and current options for the reconstruction of the different regions of the bone and skeleton, and we will discuss their potential advantages, disadvantages and complications. It is evident that apart from the impending and pathological fracture surgery it is not the first choice of treatment but rather a palliative measure. The aim of surgery is to alleviate pain, to regain mobility and improve quality of life. If possible minimal invasive techniques are performed, as they are less demanding and allow fast rehabilitation for the patient, and they are solutions that last for a lifetime. In optimal conditions radical curative surgery can be performed in about 10 to 15 per cent of the cases, and better survival is encouraging.Keywords: metastatic bone diseases, diagnostic algorhythm, prognostic factors, extremity, pelvis, surgery for metastatic bone diseases

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Massive endoprosthetic replacement for bone metastases resulting from renal cell carcinoma: Factors influencing patient survival

Cited by 34 publications

References 12 publications

Dose‐escalated radiation therapy is associated with better overall survival in patients with bone metastases from solid tumors: a propensity score‐matched study

Dose‐escalated radiation therapy is associated with better overall survival in patients with bone metastases from solid tumors: a propensity score‐matched study

Arthroplasty for Proximal Femur Fracture

Paradigmaváltás a csontmetasztázisok sebészetében. I. Végtagi és medencelokalizációjú áttétek

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