Is surgery without curettage effective for periacetabular Metastasis? Insights from a survival study of 93 patients

IF 3.4 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2024-10-10 DOI:10.1016/j.jbo.2024.100643

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Abstract

Background

The main aim of this study was to analyse the 6-month survival rates in peri-acetabular metastasis patients undergoing total hip arthroplasty (THA) with an acetabular cage and without curettage. The secondary objectives were to analyse the global survival rates, the factors influencing patient survival and to evaluate mechanical complication rates after THA.

Methods

This study was carried out on a cohort of 93 consecutive patients who underwent THA with an acetabular cage without curettage for acetabular metastasis or multiple myeloma lesions between 2010 and 2020. The National Death Registry was consulted to obtain the exact date of death of the patients; the minimum follow-up time was 2 years.

Results

The 6-month survival rate for all types of cancer was 78 % [68 – 85], the 1-year survival rate was 66 % [55 – 74], and the 5-year survival rate was 26 % [17 – 36]. The median overall survival for the cohort was 24.37 months [16.10 – 32.63]. The mean overall survival was 46.02 months [32.89 – 59.16]. At last contact, 86 % of the operated patients were walking again.

No patient died from surgery. The ECOG performance status score, the number of bone metastatic sites, the presence of visceral metastases and the number of lines of systemic therapy undertaken prior to surgery were negative survival factors. Three patients (3.2 %) had early prosthetic dislocation, 2 patients (2.2 %) showed aseptic loosening of her partial hip implant after 10 and 11 years respectively and 4 patients (4.3 %) had an early infection treated by debridement, antibiotics and implant retention to control the infection. During the follow-up period, no new femoral metastases were detected in any patient.

Conclusion

Surgery without curettage is an effective treatment for periacetabular metastasis. It gives reliable results, regardless of the type of acetabular lesion, allowing most patients to walk again and does not modify the patient’s survival.

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不进行刮宫的手术是否能有效治疗髋臼周围转移瘤？93 例患者生存研究的启示

背景本研究的主要目的是分析髋臼周围转移瘤患者在接受全髋关节置换术（THA）时使用髋臼笼和不进行刮宫术的 6 个月存活率。本研究的对象是 2010 年至 2020 年间因髋臼转移或多发性骨髓瘤病变而接受全髋关节置换术（THA）并使用髋臼笼且未进行刮治的 93 例连续患者。结果所有类型癌症的 6 个月生存率为 78% [68 - 85]，1 年生存率为 66% [55 - 74]，5 年生存率为 26% [17 - 36]。组群总生存期的中位数为 24.37 个月 [16.10 - 32.63]。平均总生存期为 46.02 个月 [32.89 - 59.16]。在最后一次联系时，86%的手术患者可以重新行走。ECOG表现状态评分、骨转移部位的数量、内脏转移灶的存在以及术前接受全身治疗的次数都是不利的生存因素。3名患者（3.2%）出现假体早期脱位，2名患者（2.2%）的部分髋关节假体分别在10年和11年后出现无菌性松动，4名患者（4.3%）出现早期感染，通过清创、抗生素和假体留置来控制感染。结论：不刮除手术是治疗髋臼周围转移瘤的有效方法。结论：不刮除手术是治疗髋臼周围转移瘤的有效方法，无论髋臼病变的类型如何，它都能带来可靠的疗效，使大多数患者能够重新行走，并且不会影响患者的存活率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.