Comparative analysis of surgical interventions in the treatment of patients with metastatic lesions of the femur in combination with pathological fractures

Cover Page

Abstract


One of the most severe complications of metastatic lesion of the skeleton is the development of a pathological fracture, which not only affects the quality of life, makes it difficult to carry out adequate systemic treatment, but also has a negative effect on survival. In case of a pathological fracture, the main method of treatment is a surgical method. The main goal of the correction is to achieve stability and reduce metastatic pain in the area of damage or fracture. Today, the most popular organ-preserving operations for metastatic lesions of the femur in combination with pathological fractures are endoprosthesis and intramedullary osteosynthesis. In this paper, a comparative analysis of the results of their use is carried out, the advantages and disadvantages of each of the methods are described.


About the authors

Jun Wang

Peoples’ Friendship University of Russia (RUDN University)

Author for correspondence.
Email: kbcbwb2000@163.com
Moscow, Russian Federation

N. V Kharchenko

Peoples’ Friendship University of Russia (RUDN University)

Email: kbcbwb2000@163.com
Moscow, Russian Federation

References

  1. Azad, G.K., Taylor B, Rubello D, et al. Molecular and functional imaging of bone metastases in breast and prostate cancers: an overview. Clin. Nucl. Med. 2016; 41(1): 44—50.
  2. Tatar, Z., Soubrier M., Dillies A.F. et al. Assessment of the risk factors for impending fractures following radiotherapy for long bone metastases using CT scan–based virtual simulation: a retrospective study. Radiat. Oncol. 2014; 16: 227.
  3. Sevimli, R., Korkmaz M.F. Analysis of orthopedic surgery of patients with metastatic bone tumors and pathological fractures. J. Int. Med. Res. 2018; 46(8): 3262—7.
  4. Skryabin V.L., Denisov A.S., Ladeyshikov V.M., Bulatov S.B. Surgical approach to the treatment of patients with pathological fractures caused by metastasis and primary malignant tumorsin locomotor system. Creative surgery and oncology 2012; 2: 69—73. (In Russ).
  5. Gdowski, A.S, Ranjan A., Vishwanatha J.K. Current concepts in bone metastasis, contemporary therapeutic strategies and ongoing clinical trials. J. Exp. Clin. Cancer Res. 2017; 36(1): 108.
  6. Macedo, F, Ladeira K., Pinho F. et al. Bone metastases: an overview. Oncol. Rev. 2017; 11: 321.
  7. Ratasvuori, M, Wedin R., Keller J. et al. Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis. Surg. Oncol. 2013; 22(2): 132—8.
  8. Simmons, J.K, Hildreth B.E., Supsavhad W. et al. Animal models of bone metastasis. Vet. Pathol. 2015; 52: 827—41.
  9. Zhu, Y.F, Ungard R., Seidlitz E. et al. Differences in electrophysiological properties of functionally identified nociceptive sensory neurons in an animal model of cancer–induced bone pain. Mol. Pain. 2016; 12: 1—14.
  10. Klaassen, Z, Howard L.E., Hoedt A. de et al. Factors predicting skeletal–related events in patients with bone metastatic castration– resistant prostate cancer. Cancer. 2017; 123(9): 1528—35.
  11. Svendsen, M.L, Gammelager H., Sværke C. et al. Hospital visits among women with skeletal–related events secondary to breast cancer and bone metastases: a nationwide population–based cohort study in Denmark. Clin. Epidemiol. 2013; 5: 97—103.
  12. Wong, K.W, Ma W.K., Wong C.W. et al. Impact of skeletal–related events on survival in patients with metastatic prostate cancer prescribed androgen deprivation therapy. Hong. Kong. Med. J. 2016; 22(2): 106—15.
  13. Radchenko A.I. Influence of surgical treatment of long bones metastases on patient’s quality of life. Oncological Journal. 2017; 11.4 (44): 47—51. (In Russ).
  14. Mirels, H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin. Orthop. Relat. Res. 1989;249: 256—64.
  15. Chandrasekar, C.R, Grimer R.J., Carter S. et al. Modular endoprosthetic replacement for tumours of the proximal femur. J. Bone Joint. Surg. Br. 2009; 91: 108—12.
  16. Angelini, A, Trovarelli G., Berizzi A. et al. Treatment of pathologic fractures of the proximal femur. Injury. 2018; 3: 77—83.
  17. Cho, Y.J, Cho Y.M., Kim S.H. et al. Clinical analysis of patients with skeletal metastasis of lung cancer. BMC Cancer. 2019; 19(1): 303.
  18. Adamietz, I.A, Wolanczyk M.J. Functional recovery after surgical stabilization and postoperative radiotherapy due to metastases of long bones. Strahlenther Onkol. 2019;195(4): 335—42.
  19. Casimiro S., Luis I., Fernandes A. et al. Analysis of a bone metastasis gene expression signature in patients with bone metastasis from solid tumors. Clin. Exp. Metastasis. 2013; 29(2): 155—64.
  20. Harvey N, Ahlmann E.R., Allison D.C. et al. Endoprostheses last longer than intramedullary devices in proximal femur metastases. Clin. Orthop. Relat. Res. 2013; 470(3): 684—91.
  21. Henrichs M.P, Krebs J., Gosheger G. et al. Modular tumor endoprostheses in surgical palliation of long–bone metastases: a reduction in tumor burden and a durable reconstruction. World. J. Surg. Oncol. 2014; 12(1): 330.
  22. Choy W.S, Kim K.J., Lee S.K. et al. Surgical Treatment of Pathological Fractures Occurring at the Proximal Femur. Injury. 2018; 49 Suppl 3: 77—83.
  23. Peterson J.R, Decilveo A.P. O’Connor BS.et al. What are the functional results and complications with long stem hemiarthroplasty in patients with metastases to the proximal femur? Clin. Orthop. Relat. Res. 2017; 475(3): 745—56.
  24. Liska F., Schmitz P., Harrasser N. et al. Metastasen der Extremitäten. Der. Unfallchirurg. 2016; 121(1): 1—10.
  25. Pala E, Henderson E.R., Calabrò T. et al. Survival of current production tumor endoprostheses: complications, functional results, and a comparative statistical analysis. J. Surg. Oncol. 2013; 108: 403—8.
  26. Issack P., Barker J., Baker M. et al. Surgical management of metastatic disease of the proximal part of the femur. J. Bone Joint. Surg. Am. 2014; 96:2091—8.
  27. Price S.L, Farukhi M.A., Jones K.B. et al. Complications of cemented long–stem hip arthroplasty in metastatic bone disease revisited. Clin. Orthop. Relat. Res. 2013; 471: 3303—7.
  28. Wedin R., Hansen B.H., Laitinen M. et al. Complications and survival after surgical treatment of 214 metastatic lesions of the Humerus. J. Shoulder. Elbow. Surg. 2014; 21(8): 1049—55.
  29. Janssen, S.J, Teunis T., Homicek F.J. et al. Outcome after fixation of metastatic proximal femoral fractures: A systematic review of 40 studies. J. Surg. Oncol. 2016; 114(4): 507—19.
  30. Menendez L.R, Ahlmann E.R., Kermani C., Gotha H. Endoprosthetic replacement for neoplasms of the proximal femur. Clin. Orthop. Relat. Res. 2013; 450: 46—51.
  31. Zacherl M., Gruber G., Glehr M. et al. Surgery for pathological proximal femoral fractures, excluding femoral head and neck fractures: resection vs. stabilization. Int. Orthop. 2013; 35(10):1537—43.
  32. Radchenko A.I., Zhukovec A.G., Bogdaev Ju.M. Treatment results of pathological fractures of the long bones in patients with breast cancer. Bone and soft tissue sarcomas. 2016; 3: 11—15. (In Russ).
  33. Malviya A., Gerrand C. Evidence for orthopaedic surgery in the treatment of metastatic bone disease of the extremities: a review article. Palliat Med. 2013; 26(6): 788—96.
  34. Tharmalingam S., Chow E., Harris K. et al. Quality of life measurement in bone metastases: a literature Review. J. Pain Res. 2013; 1: 49—58.

Statistics

Views

Abstract - 80

PDF (Russian) - 25

Cited-By


PlumX

Dimensions


Copyright (c) 2020 Wang J., Kharchenko N.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies