Profile of Surgically-treated Metastatic Extremity Bone Tumours at a University Hospital in Hong Kong

Abstract

Background/Purpose Metastatic deposits in bones increase overall morbidity in cancer patients. The orthopaedic oncologist aims at controlling the skeletal morbidity as a way of reducing the overall morbidity in the survival period of the cancer patient. This study investigated the characteristics of metastatic extremity bone tumours requiring surgical treatment, with a view to setting a template for a local database of extremity metastatic bone tumours in Hong Kong. Methods A retrospective review of metastatic extremity bone tumours treated surgically at a university hospital in Hong Kong, from January 2006 to December 2015, is presented. Results In total, 126 patients were studied. The lung (28.6%) was the most common source of metastasis to the extremity bones. The femur (70.1%) was most commonly involved. Pathological fractures (47.4%) were the most common indications for surgery. Intramedullary nailing (57.3%) was the most common surgical treatment. The overall postoperative complication rate was 8.7%. The mean duration of follow-up was 10.8 ± 4.1 months. Furthermore, 79.4% of the patients died within the study period, with mean duration of postoperative survival of 6.1 ± 1.1 months. Spinal compression ( p = 0.001), indication for surgery ( p = 0.001), age of the patient ( p = 0.001), and option of surgical treatment ( p = 0.000319) were found to have significantly affected the duration of postoperative survival. Conclusion The surgical management of extremity bone metastasis is a key consideration in averting potentially crippling morbidity. Options of treatment need be carefully chosen in appropriate patients for a good outcome.