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Prognostic role of en‐bloc resection and late onset of bone metastasis in patients with bone‐seeking carcinomas of the kidney, breast, lung, and prostate: SSG study on 672 operated skeletal metastases
Author(s) -
Ratasvuori Maire,
Wedin Rikard,
Hansen Bjarne H.,
Keller Johnny,
Trovik Clement,
Zaikova Olga,
Bergh Peter,
Kalen Anders,
Laitinen Minna
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23654
Subject(s) - medicine , proportional hazards model , kidney cancer , prostate cancer , metastasis , bone metastasis , prostate , oncology , multivariate analysis , lung , breast cancer , radiation therapy , surgery , cancer , renal cell carcinoma
Background and Objectives In metastatic disease, decisions regarding potential surgery require reliable data about the patient's survival. In this study, we evaluated different prognostic factors and their impact in four common primary tumors causing bone metastases. Methods Data were acquired from the Scandinavian Sarcoma Group (SSG) metastasis registry. The patients underwent surgery between July 1999 and July 2009. This study included breast, prostate, lung, and kidney cancer cases, with a total of 672 operated non‐spinal metastases. Differences in prognostic factors were evaluated using the Kaplan‐Meier method with long‐rank test. Cox regression multivariate analysis was performed to identify statistically independent prognostic factors. Results Significant factors affecting survival were the presence of organ metastases, overall heath status, and disease load. In kidney cancer, en bloc resection of solitary metastases was associated with a significant fourfold longer survival compared to intralesional surgery. Preoperative radiotherapy was associated with higher complication and reoperation rates. Conclusions This data summary is important tool for clinicians to evaluate survival and choose treatment options for patients suffering from metastatic bone disease. J. Surg. Oncol. 2014; 110:360–365 . © 2014 Wiley Periodicals, Inc.