Patient survival following joint replacement due to metastatic bone disease – comparison of overall patient and prostheses survival between cohorts treated in two different time-periods

Abstract

We were not able to identify an increased survival after surgery for MBD over time, however, we found an increased interval from diagnosis to surgery for MBD. This study suggests that revision surgery for MBD does not pose a risk for survival.

External Validation and Optimization of the SPRING Model for Prediction of Survival After Surgical Treatment of Bone Metastases of the Extremities

“…The SPRING Model Proposed by this research group in 2016 [19], the 2008-SPRING model predicts survival 3, 6, and 12 months after surgery for metastatic bone disease in the extremities. We used a logistic regression model to build the model with data from a cohort of 130 patients who had joint replacement surgery from 2003 to 2008 (patients who were included in the early cohort of the COpenhagen BOne Metastasis database [COBOM] database [12]). We presented the model as three nomograms, one for each endpoint (survival at 3, 6, and 12 months after surgery for metastatic bone disease in the extremities).…”

Biochemical Variables are Predictive for Patient Survival after Surgery for Skeletal Metastasis. A Prediction Model Development and External Validation Study

“…We used Kaplan-Meier estimate to compare overall survival between groups. Overall survival for these two groups has previously been described by Hovgaard et al [25] 3. RESULTS…”

“…Patient demographics can be addressed in Tables 1 and 2. The cohorts contain no differences in age, primary cancer, fracture, visceral metastasis, solitary metastasis, ASA score or KPS between the test and validation cohort [25]. However, days from the diagnosis of cancer to surgery for MBDex did differ between the two cohorts (p < 0.001) with a shorter period for the validation cohort.…”

“…This study obtained ethical approval by the Danish Health Authorities (ID-no: 3.3013-880/1) and Danish Data Protection Agency (ID-no: 30-1222). Patients were identified from the COpenhagen BOne Metastases Database (COBOM database [25]), which contains retrospectively collected clinical data from January 1 st 2003 to 31 st December 2013 of patients treated in our center for MBDex with joint replacement surgery or a diaphyseal spacer. Our center is one of two tertiary referral centers for orthopedic oncology in Denmark and therefore the COBOM database can be considered to be representative for a population based cohort of patients having highly specialized treatment for MBDex.…”

Use of endoprostheses for proximal femur metastases results in a rapid rehabilitation and low risk of implant failure. A prospective population-based study

“…Also, no studies included in the review accounts for competing risks, which is known to cause overestimation of revision risk in orthopaedic procedures [24,25]. This has been shown to be of great influence in MBD patients with a high mortality [26]. As the general perception [13] is to use an endoprosthesis in long-term survivors and to treat short-term survivors with internal fixation, it is difficult to evaluate if we over or underestimate revision risk in these two patient populations.…”