Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector3463210.17816/KMJ2020-685Theoretical and clinical medicineТеоретическая и клиническая медицинаResearch ArticleAnalysis of postoperative prognostic factors in patients with long bones metastatic lesionsАнализ факторов послеоперационного прогноза у пациентов с метастатическим поражением длинных трубчатых костейhttps://orcid.org/0000-0001-5625-0509WangJunВанЦзюнь
Russian Federation
kbcbwb2000@163.comKharchenkoN VХарченкоНаталья Владимировна
Russian Federation
kharchenco-nv@rudn.ruKarpenkoV YКарпенкоВадим Юрьевич
Russian Federation
doctor-kv@yandex.ruPeoples' Friendship University of RussiaРоссийский университет дружбы народовNational Medical Research Center of Traumatology and Orthopedics named after N.N. PriorovaНациональный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова2710202010156856900806202018092020Copyright ©; 2020, Wang J., Kharchenko N.V., Karpenko V.Y.Copyright ©; 2020, Ван Ц., Харченко Н.В., Карпенко В.Ю.2020Wang J., Kharchenko N.V., Karpenko V.Y.Ван Ц., Харченко Н.В., Карпенко В.Ю.http://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/34632

Currently, with the development of the concept of cancer treatment, the survival rate of patients has increased significantly, but the percentage of the frequency of various metastatic lesions remains high. The bones of the skeleton are one of the main parts of metastases. In cancer patients, bone metastases usually mean that the disease is at an advanced stage, and the prognosis is not good. These patients often suffer from many complications, including pain, decreased mobility, pathological fractures, etc. The quality of life of patients is seriously deteriorating. Therefore, the main goal of surgical treatment of patients with bone metastases is the earliest possible restoration the function of the affected limb, pain relief, prevention of pathological fractures and the improvement of the quality of life of patients after surgery. This literature review analyzes the incidence of bone metastases in patients, and the dependence of metastatic lesions of long tubular bones on localization incidence of bone metastases in different body parts. The domestic and foreign literature on the surgical treatment of patients with metastatic bone lesions was analyzed. The results of the analysis show that the features of surgical treatment are becoming the main factors influencing the prognosis in patients with metastatic lesions of the long bones.

В настоящее время, с развитием концепции лечения рака, выживаемость больных значительно возросла, но остаётся высокой частота различных метастатических поражений. Кости скелета бывают одной из основных локализаций метастазов — наиболее часто это длинные трубчатые кости. У онкологических больных появление метастазов в кости обычно означает, что заболевание находится на поздней стадии, и прогноз плохой. Эти пациенты часто страдают от многих осложнений, включая боль, снижение подвижности, патологические переломы и т.д. Серьёзно ухудшается качество жизни пациентов. В свете этого основными целями оперативного лечения пациентов с метастазированием в кости становятся как можно более раннее восстановление функций поражённой конечности, облегчение боли, предотвращение патологических переломов и улучшение качества жизни пациентов после операции. В данном литературном обзоре проведён анализ частоты появления метастазов в кости у пациентов, а также зависимость метастатических поражений длинных трубчатых костей от локализации опухоли в разных отделах. Проанализирована отечественная и зарубежная литература по хирургическому лечению пациентов с метастатическим поражением костей. Результаты анализа показывают, что особенности хирургического лечения становятся основными факторами, влияющими на прогноз у пациентов с метастатическими поражениями длинных трубчатых костей.

bone metastaseslong tubular bonessurgical treatmentcancer patientsosteosynthesisметастазы в костяхдлинные трубчатые костихирургическое лечениеонкологические больныеостеосинтезGuzik G. Oncological and functional results after surgical treatment of bone metastases at the proximal femur. BMC Surg. 2018; 18 (1): 5. DOI: 10.1186/s12893-018-0336-0.Li S., Peng Y., Weinhandl E.D. et al. Estimated number of prevalent cases of metastatic bone disease in the US adult population. Clin. Epidemiol. 2012; 4: 87–93. DOI: 10.2147/CLEP.S28339.Harries M., Taylor A., Holmberg L. et al. Incidence of bone metastases and survival after a diagnosis of bone metastases in breast cancer patients. Cancer Epidemiol. 2014; 38 (4): 427–434. DOI: 10.1016/j.canep.2014.05.005.Wong K.W., Ma W.K., Wong C.W. et al. Impact of skeletal-related events on survival in patients with meta­static prostate cancer prescribed androgen deprivation therapy. Hong Kong Med. J. 2016; 22 (2): 106–115. DOI: 10.12809/hkmj144449.Radchenko A.I., Zhukovec A.G., Bogdaev Ju.M. Surgical treatment for the solitary long bone metastasis from renal cell carcinoma. Onkologicheskiy zhurnal. 2016; 10 (2): 50–56. (In Russ)Радченко А.И., Жуковец А.Г., Богдаев Ю.М. Хирургическое лечение одиночных метастазов рака почки в длинных трубчатых костях. Онкол. ж. 2016; 10 (2): 50–56.Cho Y.J., Cho Y.M., Kim S.H. et al. Clinical analysis of patients with skeletal metastasis of lung cancer. BMC Cancer. 2019; 19 (1): 303. DOI: 10.1186/s12885-019-5534-3.Bhandari V., Jain R.K. A retrospective study of incidence of bone metastasis in head and neck cancer. J. Cancer Re.s Ther. 2013; 9 (1): 90–93. DOI: 10.4103/0973-1482.110385.Kapoor A., Sharma S., Kalwar A. et al. Analysis of bone metastasis in head and neck squamous cell carcinoma: experience of a regional cancer center. Clin. Cancer Invest. J. 2015; 4 (2): 206–210. DOI: 10.4103/2278-0513.148916.Zhang H., Zhu W., Biskup E. et al. Incidence, risk factors and prognostic characteristics of bone metastases and skeletal-related events (SREs) in breast cancer patients: A systematic review of the real world data. J. Bone Oncol. 2018; 11: 38–50. DOI: 10.1016/j.jbo.2018.01.004.Koizumi M., Yoshimoto M., Kasumi F. et al. An open cohort study of bone metastasis incidence following surgery in breast cancer patients. BMC Cancer. 2010; 10: 381. DOI: 10.1186/1471-2407-10-381.Yamashiro H., Takada M., Nakatani E. et al. Prevalence and risk factors of bone metastasis and skeletal rela­ted events in patients with primary breast cancer in Japan. Int. J. Clin. Oncol. 2014; 19 (5): 852–862. DOI: 10.1007/s10147-013-0643-5.Casimiro S., Luis I., Fernandes A. et al. Analysis of a bone metastasis gene expression signature in patients with bone metastasis from solid tumors. Clin. Exp. Metastasis. 2012; 29 (2): 155–164. DOI: 10.1007/s10585-011-9438-0.Svendsen M.L., Gammelager H., Yong M. et al. Hospital visits among women with skeletal-related events secondary to breast cancer and bone metastases: a nationwide population-based cohort study in Denmark. Clin. Epidemiol. 2013; 5: 97–103. DOI: 10.2147/CLEP.S42325.Vermorken J.B., Specenier P. Optimal treatment for recurrent metastatic head and neck cancer. Ann. Oncol. 2010; 21 (suppl. 7): vii 252–261. DOI: 10.1093/annonc/mdq453.Stopeck A.T., Lipton A., Body J.J. et al. Denosumab compared with zoledronic acid for the treatment of bone metastases in patients with advanced breast cancer: a randomized, double-blind study. J. Clin. Oncol. 2010; 28 (35): 5132–5139. DOI: 10.1200/JCO.2010.29.7101.Ratasvuori M., Wedin R., Keller J. et al. Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis. Surg. Oncol. 2013; 22 (2): 132–138. DOI: 10.1016/j.suronc.2013.02.008.Miklós Szendrői, Imre Antal, Attila Szendrői et al. Diagnostic algorithm, prognostic factors and surgical treatment of metastatic cancer diseases of the long bones and spine. EFFORT Open Rev. 2017; 2 (9): 372–381. DOI: 10.1302/2058-5241.2.170006.Lee J., Hodgson D., Chow E. et al. A phase II ­trial of palliative radiotherapy for metastatic renal cell carcinoma. Cancer. 2005; 104 (9): 1894–1900. DOI: 10.1002/cncr.21410.Sahi S.C., Knox J.J., Clemons M. et al. ­Renal cell carcinoma bone metastases: clinical ­advances. Ther. Adv. Med. Oncol. 2010; 2 (2): 75–83. DOI: 10.1177/1758834009358417.Biermann J.S., Holt G.E., Lewis V.O. et al. Metastatic bone disease: diagnosis, evaluation, and treatment. J. Bone Joint Surg. Am. 2009; 91 (6): 1518–1530. PMID: 19487533.Sevimli R., Korkmaz M.F. Analysis of orthopedic surgery of patients with metastatic bone tumors and pathological fractures. J. Int. Med. Res. 2018; 46 (8): 3262–3267. DOI: 10.1177/0300060518770958.Tokuda O., Harada Y., Ohishi Y. et al. Investigation of computer-aided diagnosis system for bone scans: a retrospective analysis in 406 patients. Ann. Nucl. Med. 2014; 28 (4): 329–339. DOI: 10.1007/s12149-014-0819-8.Oliveira M.B.D.R., Marques B.C., Matos R.A. et al. Pathological fractures due to bone metastases from lung cancer: risk factors and survival. Acta. Ortop. Bras. 2018; 26 (6): 388–393. DOI: 10.1590/1413-785220182606201669.Piccioli A., Maccauro G., Rossi B. et al. Surgical treatment of pathologic fractures of humerus. Injury. 2010; 41 (11): 1112–1116. DOI: 10.1016/j.injury.2010.08.015.Harvey N., Ahlmann E.R., Allison D.C.et al. Endoprostheses last longer than intramedullary devices in pro­ximal femur metastases. Clin. Orthop. Relat. Res. 2011; 470 (3): 684–691. DOI: 10.1007/s11999-011-2038-0.Liska F., Schmitz P., Harrasser N.et al. Metasta­tic disease in long bones: Review of surgical treatment options. Der Unfallchirurg. 2018; 121 (1): 37–46. DOI: 10.1007/s00113-016-0282-1.Alvi H.M., Damron T.A. Prophylactic stabilization for bone metastases, myeloma, or lymphoma: do we need to protect the entire bone? Clin. Orthop. Relat. Res. 2013; 471 (3): 706–714. DOI: 10.1007/s11999-012-2656-1.Miller B., Soni E.E., Gibbs C.P.et al. Intramedullary nails for long bone metastases: why do they fail? Orthopedics. 2011; 34 (4): 274. DOI: 10.3928/01477447-20110228-12.Laitinen M., Ratasvuori M., Pakarinen T.K. The multi-modal approach to metastatic diseases. European Intructional Lectures. Berlin, Heidelberg: Springer. 2012; 35–44. DOI: 10.1007/978-3-642-27293-6_4.Henrichs M.P., Krebs J., Gosheger G. et al. Modular tumor endoprostheses in surgical palliation of long-bone metastases: a reduction in tumor burden and a durable reconstruction. World J. Surg. Oncol. 2014; 12: 330. DOI: 10.1186/1477-7819-12-330.Wedin R., Hansen B.H., Laitinen M. et al. Complications and survival after surgical treatment of 214 metastatic lesions of the humerus. J. Shoulder Elbow Surg. 2012; 21 (8): 1049–1055. DOI: 10.1016/j.jse.2011.06.019.Weiss K.R., Bhumbra R., Biau D.J.et al. Fixation of pathological humeral fractures by the cemented plate technique. J. Bone Joint Surg. Br. 2011; 93 (8): 1093–1097. DOI: 10.1302/0301-620X.93B8.26194.Willeumier J.J., van der Linden Y.M., van de Sande M.A.J. et al. Treatment of pathological fractures of the long bones. EFFORT Open Rev. 2017; 1 (5): 136–145. DOI: 10.1302/2058-5241.1.000008.Ahn S.G., Lee H.M., Cho S.H. et al. Prognostic factors for patients with bone-only metastasis in breast cancer. Yonsei Med. J. 2013; 54 (5): 1168–1177. DOI: 10.3349/ymj.2013.54.5.1168.Bickels J., Dadia S., Lidar Z. Surgical management of metastatic bone disease. J. Bone Joint Surg. 2009; 91 (6): 1503–1516. DOI: 10.2106/JBJS.H.00175.Scott E., Klement M.R., Brigman B.E.et al. Beyond Mirels: Factors influencing surgical outcome of metastasis to the extremities in the modern era. J. Surg. Orthop. Adv. 2018; 27 (3): 178–186. DOI: 10.3113/JSOA.2018.0178.