ArticleCancers2022
Surgical Treatment of Metastatic Bone Disease in the Appendicular Skeleton: A Population-Based Study.
Article in Cancers, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- Intramedullary Nailing Versus Modular Megaprosthesis in Pathological Humeral Fractures: A 10-Year Retrospective Comparative Study.Diseases (Basel, Switzerland) · 2026Article
- Metastatic bone disease in proximal femur. Outcome of surgical treatments. - Do we know what to do?Journal of bone oncology · 2025Article
- Bone cement implantation syndrome in patients with cemented endoprostheses for metastatic bone disease in the femur.Journal of bone oncology · 2025Article
- Surgical management of metastatic lesions in the proximal femur: a systematic review.EFORT open reviews · 2025Article
- Risk Factors for Early Postoperative Morbidity and Mortality following Extremity Metastatic Pathologic or Impending Fracture Fixation.International journal of surgical oncology · 2024Article
- Major surgery for metastatic bone disease is not a risk for 30-day mortality: a population-based study from Denmark.Acta orthopaedica · 2023Article
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Authors and funding
8 authors at 5 institutions in 1 country.
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Abstract
Background: Population-based studies of patients with bone metastases in the appendicular skeleton (aBM) requiring surgery for complete or impending fracture are rare. In this epidemiologically-based observational study we created a large population-based cohort of patients treated for aBM, aiming to: (1) monitor possible time-related changes of the incidence of surgical treatment of aBM-lesions, (2) examine differences in the population and care of patients treated at different treatment centers and (3) examine if findings from a previous pilot study regarding absence of a suitable biopsy of the lesions representing debut of cancer or a relapse has improved the awareness of aBM and hereby increased the focus on regular tumor biopsies and follow-up imaging of cancer patients. Methods: We examined a population-based cohort consisting of all patients treated for aBM 2014−2019. Procedures were performed at five secondary surgical centers (SSC) or one tertiary referral Musculoskeletal Tumor Center (MTC). Patients were followed until end of study (30 September 2021) or death. No patients were lost to follow-up. Results: Four-hundred-fifty-seven patients (493 primary aBM-lesions, 482 procedures) were included. Annual incidence of aBM-surgery was 46 aBM-lesions/million. MTC-patients had a significant better preoperative status than SSC-patients considering factors known for survival. Patients with complete fracture experienced longer surgical delay when treated at MTC compared to SSC: 4 (1−9) and 1 (1−3) days (p < 0.001), respectively. Overall survival for the entire cohort was 37% and 11% at 1 and 5 years (MTC and SSC 1 and 5 year respectively: 44% and 15% vs. 29% and 5%, p < 0.001). In patients with debut or relapse of cancer, 8% and 9% had insufficient biopsies, and 21% and 12% had no biopsy, respectively. Comparison showed no change over time. Conclusions: The current study highlights the low awareness on treating aBM at SSC and emphasizes the importance of caution in interpretation of studies not representing an entire population, thus introducing selection bias.
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