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Can surgical management of bone metastases improve quality of life among women with gynecologic cancer?

Ji T, Eskander R, Wang Y, Sun K, Hoang BH, Guo W - World J Surg Oncol (2014)

Bottom Line: Patients were followed for an average period of 13.8 months (range, 2 to 34 months).The mean VAS score was 5.8 preoperatively compared with 2.1, 3 months after surgery.The mean pre and postoperative ECOG performance status grades were 3.1 and 2.3, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing 100044, China. bonetumor@163.com.

ABSTRACT

Background: The evaluation, counseling, and management of gynecologic patients with bone metastasis remain a challenge for clinicians. In order to critically evaluate the role of surgery, we retrospectively analyzed the records of 18 patients surgically treated for metastatic gynecologic tumors of bone, focusing on quality of life, local tumor control, and survival.

Methods: Eighteen patients underwent surgical procedures for the treatment of bone metastases secondary to gynecologic cancer between September 2003 and April 2012. The primary cancer sites included the uterus (n = 10), the cervix (n = 5), and an ovary (n = 3). Patients were followed for an average period of 13.8 months (range, 2 to 34 months). A visual analog pain scale (VAS) and Eastern Cooperative Oncology Group (ECOG) performance status were evaluated both pre- and postoperatively.

Results: The median survival time following diagnosis of bone metastasis was 10.0 months. The mean VAS score was 5.8 preoperatively compared with 2.1, 3 months after surgery. The mean pre and postoperative ECOG performance status grades were 3.1 and 2.3, respectively.

Conclusions: The prognosis of gynecological cancer patients with bone metastasis is poor. Some patients had improvement in their quality of life after surgical intervention for bone metastases; however, novel integrated treatment modalities should be investigated.

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The patient was diagnosed for cervical cancer (Number 14). X-ray (A) and computed tomography (CT) (B) showed a large sclerotic lesion involving the sacrum. Intraoperative picture (C) demonstrated sacral nerve roots preserved after resection of metastatic lesion. Pathological examination revealed squamous cell carcinoma (D) (hematoxylin and eosin (H&E) stain, ×100). Postoperative x-ray (E) showed screw-rod system reconstruction.
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Figure 1: The patient was diagnosed for cervical cancer (Number 14). X-ray (A) and computed tomography (CT) (B) showed a large sclerotic lesion involving the sacrum. Intraoperative picture (C) demonstrated sacral nerve roots preserved after resection of metastatic lesion. Pathological examination revealed squamous cell carcinoma (D) (hematoxylin and eosin (H&E) stain, ×100). Postoperative x-ray (E) showed screw-rod system reconstruction.

Mentions: Indications for orthopedic surgery [15] included intractable pain in ten patients (56%), impending or pathological fracture in five (28%) patients, and spinal cord compression in three patients (16%). Wide resection consisting of en bloc removal of the bone lesion with an envelope of normal tissue and reconstruction was done in five patients. Intra-lesional curettage followed by internal fixation was performed in 13 patients (Figure 1). Palliative decompression for spinal cord compression was performed in four patients. All the patients received bisphosphonate treatment monthly after surgery.


Can surgical management of bone metastases improve quality of life among women with gynecologic cancer?

Ji T, Eskander R, Wang Y, Sun K, Hoang BH, Guo W - World J Surg Oncol (2014)

The patient was diagnosed for cervical cancer (Number 14). X-ray (A) and computed tomography (CT) (B) showed a large sclerotic lesion involving the sacrum. Intraoperative picture (C) demonstrated sacral nerve roots preserved after resection of metastatic lesion. Pathological examination revealed squamous cell carcinoma (D) (hematoxylin and eosin (H&E) stain, ×100). Postoperative x-ray (E) showed screw-rod system reconstruction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125343&req=5

Figure 1: The patient was diagnosed for cervical cancer (Number 14). X-ray (A) and computed tomography (CT) (B) showed a large sclerotic lesion involving the sacrum. Intraoperative picture (C) demonstrated sacral nerve roots preserved after resection of metastatic lesion. Pathological examination revealed squamous cell carcinoma (D) (hematoxylin and eosin (H&E) stain, ×100). Postoperative x-ray (E) showed screw-rod system reconstruction.
Mentions: Indications for orthopedic surgery [15] included intractable pain in ten patients (56%), impending or pathological fracture in five (28%) patients, and spinal cord compression in three patients (16%). Wide resection consisting of en bloc removal of the bone lesion with an envelope of normal tissue and reconstruction was done in five patients. Intra-lesional curettage followed by internal fixation was performed in 13 patients (Figure 1). Palliative decompression for spinal cord compression was performed in four patients. All the patients received bisphosphonate treatment monthly after surgery.

Bottom Line: Patients were followed for an average period of 13.8 months (range, 2 to 34 months).The mean VAS score was 5.8 preoperatively compared with 2.1, 3 months after surgery.The mean pre and postoperative ECOG performance status grades were 3.1 and 2.3, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing 100044, China. bonetumor@163.com.

ABSTRACT

Background: The evaluation, counseling, and management of gynecologic patients with bone metastasis remain a challenge for clinicians. In order to critically evaluate the role of surgery, we retrospectively analyzed the records of 18 patients surgically treated for metastatic gynecologic tumors of bone, focusing on quality of life, local tumor control, and survival.

Methods: Eighteen patients underwent surgical procedures for the treatment of bone metastases secondary to gynecologic cancer between September 2003 and April 2012. The primary cancer sites included the uterus (n = 10), the cervix (n = 5), and an ovary (n = 3). Patients were followed for an average period of 13.8 months (range, 2 to 34 months). A visual analog pain scale (VAS) and Eastern Cooperative Oncology Group (ECOG) performance status were evaluated both pre- and postoperatively.

Results: The median survival time following diagnosis of bone metastasis was 10.0 months. The mean VAS score was 5.8 preoperatively compared with 2.1, 3 months after surgery. The mean pre and postoperative ECOG performance status grades were 3.1 and 2.3, respectively.

Conclusions: The prognosis of gynecological cancer patients with bone metastasis is poor. Some patients had improvement in their quality of life after surgical intervention for bone metastases; however, novel integrated treatment modalities should be investigated.

Show MeSH
Related in: MedlinePlus