En bloc resection and intercalary prosthesis implantation for the treatment of humeral diaphyseal bone metastases
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ORIGINAL PAPER
En bloc resection and intercalary prosthesis implantation for the treatment of humeral diaphyseal bone metastases Feifei Pu 1 & Zhicai Zhang 1 & Baichuan Wang 1 & Jianxiang Liu 1 & Zengwu Shao 1 Received: 14 August 2020 / Accepted: 30 September 2020 # SICOT aisbl 2020
Abstract Purpose To evaluate the short-term clinical efficacy and complications of en bloc resection and intercalary prosthesis implantation for the treatment of humeral diaphyseal bone metastases. Methods A total of 21 patients with humeral diaphyseal bone metastases treated with en bloc resection and intercalary prosthesis implantation from August 2014 to August 2019 were retrospectively analysed. The visual analogue scale (VAS), Musculoskeletal Tumour Society (MSTS) scale, International Society of Limb Salvage (ISOLS) scoring system, Karnofsky Performance Status (KPS) scale, and Nottingham Health Profile (NHP) scale were used to assess pain, limb function, and quality of life. Survival of the patients was analysed using the Kaplan-Meier method. Results The patients were followed up for 12–57 months (mean: 22 months); the operative time was 68–114 minutes (mean: 76.24 min); the osteotomy length was 6.5–10 cm (mean: 8.02 cm); and the intra-operative blood loss was 95–125 ml (mean: 104.71 ml). At three, six and 12 months after surgery, the VAS and NHP scores were lower, whereas the MSTS, ISOLS, and KPS scores were higher than those before surgery, and the differences were statistically significant (P < 0.05). The survival time was four to 24 months (mean: 19.46 months). Thesix month and one year survival rates were 80.95% and 52.38%, respectively. During the follow-up period, no complications occurred except for aseptic prosthesis loosening in one patient. Conclusions En bloc resection and intercalary prosthesis implantation can reduce pain, improve limb function, prolong survival time, and improve quality of life in patients with humeral diaphyseal bone metastases. Keywords Humeral shaft . Bone metastases . En bloc resection . Intercalary prosthesis . Surgical treatment
Introduction The long bones of the limbs are common sites of bone metastases, with the humerus being the second most vulnerable site, following the femur [1]. Humeral diaphyseal bone metastases can cause severe pain, limb dysfunction, and reduced quality of life [2]. Bone metastases reduce bone strength and lead to pathological fractures, which are important risk factors for death [3]. Selecting the best treatment regimen is important
* Jianxiang Liu [email protected] * Zengwu Shao [email protected] 1
Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei, People’s Republic of China
to prevent and treat pathological fractures in patients with bone metastases [4]. With recent improvements in radiotherapy, chemotherapy, surgical procedures, targeted therapy, and immunotherapy for comprehensive cancer treatment, good outcomes have been achieved in patients w
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