Length of Time to Clinical Improvement After Orthopedic Oncology Surgery in Patients With Metastatic Cancer: A Multi-Institution Patient-Reported Outcome Study.

Abstract

Background: Currently, there is a paucity of data that describes the length of time required to realize improvement in pain and function following surgery for patients with metastatic cancer to bone.

Methods: One hundred patients with impending or completed pathologic fractures due to metastatic cancer to bone were enrolled in this prospective cohort study. Outcomes were measured with a Computer Adaptive Test of Patient Reported Outcomes for Pain Interference and Physical Function domains, to determine the time required to achieve a Minimal Clinically Important Difference (MCID) in the tested domains.

Results: Eighty-one patients were included in the analysis. Thirty-two patients (39.5%) survived and completed the follow-up to 1 year, while 23 (28.4%) died before the end of the data collection. Fifty-one patients (63.0%) achieved at least a 5-point improvement in Physical Function and 59 (72.8%) achieved at least a 5-point improvement in Pain Interference. The time to achieve the MCID was 6 weeks for the Physical Function and 4 weeks for the Pain Interference domain.

Conclusion: The majority of patients with impending or completed pathologic fractures due to metastatic cancer see clinically important improvements in pain and function after surgery in an average of 4 and 6 weeks, respectively.