Surgical treatment outcomes in patients with metastases inlongbones
Objective. To demonstrate surgical treatment outcomes for combined modality treatment in patients with metastases in long bones. Materials and methods. Over the periods 2006-2010 surgery for metastases in long bones has been performed in 37 patients. Solitary metastases occurred in 10 (28%) cases and multiple metastases were diagnosed in 27 (72%) patients. The danger of pathological fracture was in 17 (46%) patients and established fractures were diagnosed in 20 (54%) cases. Segmental resection with endoprosthetic replacement was done in 14 (38%) patients. External (intramedullary nailing and external fixation) osteosynthesis was done in 23 (62%) patients. Results. There were no intraoperative complications. Patients which received orthopedics care for metastases in long bones were activated on the 2-7 day. 33 (89%) patients had no or mild pain syndrome in postoperative period. Improvement of general condition after surgery occurred in 35 (94%) patients. Improvement of orthopedic status was noticed in 32 (86%) patients. Oncological criteria included assessment of survival by Kaplan Meier survival analysis. The follow-up ranged from 2 to 55 months. The highest mean follow-up period of 21 months was in patients with metastases ofbreast cancer. Conclusion. Appropriate recovery of functional activity using organ preserving surgery (endoprosthetic replacement, external osteosynthesis) in orthopedics in patients with bone metastases improves quality of their life and is very important for social and psychological adaptation.