DOS Kongressen 2014 ·
107
Prognostic preoperative parameters for survival in
patients treated by joint replacement surgery for
extremity bone metastases
Michala Skovlund Sørensen, Klaus Hindsø, Kristine Grubbe Gregersen, Michael
Mørk Petersen
Ortopædkirurgisk klinik, Rigshospitalet
Background:
Estimation of patient survival is important when planning surgical
treatment of metastatic bone disease (MBD) of the extremities. We have done
a single centre study evaluating prognostic preoperative parameters for patient
survival after joint replacement (JR) surgery in patients with MDB of the ap-
pendicular bones.
Purpose / Aim of Study:
To estimate prognostic preoperative parameters for
patient survival, in patients receiving JR, due to MBD in the appendicular skel-
eton.
Materials and Methods:
We included 130 patients that received a JR due to
MBD during the period Jan ‘03 to Dec ‘08 at the Department of Orthopaedic
Surgery, Rigshospitalet, Copenhagen. The cohort was followed with regard for
survival until death or marts 29th ‘11. The following data were registered: age,
gender, pathological fracture/impending fracture, number of bony metastases,
visceral metastases, erythrocyte sedimentation rate (SR), C reactive protein
(CRP), haemoglobin (HGB), Karnofsky score, ASA score, and primary type of
cancer. Statistics: Kaplan-Meier survival analysis with logrank test and Cox pro-
portional hazard regression analysis.
Findings / Results:
The calculated probability of survival after surgery was
51% and 39% at 6 months and 1 years of follow-up. The median survival time
was 7 (0.03–96) months. Univariate analysis showed that all preoperative pa-
rameters were statistical significant predictors for survival except gender and
pathological fracture/impending fracture. Multivariate analysis showed that
visceral metastasis, Karnofsky score < 7, ASA group 3 or 4, HGB < 8 and primary
type of cancer remained statistical significant predictors of survival.
Conclusions:
We have been able to identify preoperative parameters that cor-
relate to patient survival in patients operated on, with a JR, because of MDB in
the appendicular skeleton.
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