Metastases of the femur: analysis of 124 patients
DOI:
https://doi.org/10.69133/aoth.v77i2.535Keywords:
Metastases; femur; survival; resection; nailing; reconstruction.Abstract
Background: There are several studies providing surgical indications for patients treated for femoral metastases. The purpose of this study is to highlight the survival rates of patients with femoral metastases and provide information concerning the treatment of patients suffering from femoral impending fractures and those treated for actual pathological fractures.
Materials and Methods: We retrospectively studied 124 patients with femoral metastases from different cancers. The patients were treated with intramedullary nailing, tumor excision and arthroplasty reconstruction, or tumor resection and megaprosthetic reconstruction from 2013 and 2023. The mean follow-up was 18 months. Analysis of patients’ survival rates was done based on the cancer type, number and location of metastases, presence of a pathological fracture, and type of surgery.
Results: The overall survival of the patients at 60 months was 16%. The presence of an actual pathological fracture, as well as the type of surgery were the only univariate survival predictors, with the first being the only multivariate predictor. Survival was statistically significantly higher in patients treated with tumor excision and arthroplasty reconstruction and patients treated with tumor resection and megaprosthetic reconstruction compared to those treated with nailing (p= 0.002). The survival of the patients with an impending fracture was statistically significantly higher compared to those with an actual pathological fracture (p= 0.001). There was no difference in survival among males and females, cancer types or number and location of femoral metastases. The complications rate was 7.2%; the most common complication was infection.
Conclusions: Survival rates were higher in patients with femoral metastases treated with tumor excision and arthroplasty reconstruction, or tumor resection and megaprosthetic reconstruction compared to those treated with nailing. Patients with an impending fracture had higher survival rates compared to patients with an actual pathological fracture.
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