Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone disease
Aims: The modern prevalence of primary tumours causing metastatic bone disease is ill-defined in the oncological literature. Therefore, the purpose of this study is to identify the prevalence of primary tumours in the setting of metastatic bone disease, as well as reported rates of pathological frac...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The British Editorial Society of Bone & Joint Surgery
2023-06-01
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| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.46.BJO-2023-0042.R1 |
| _version_ | 1827915077523603456 |
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| author | Alexander B. Christ Amit S. Piple Brandon S. Gettleman Andrew Duong Matthew Chen Jennifer C. Wang Nathanael D. Heckmann Lawrence Menendez |
| author_facet | Alexander B. Christ Amit S. Piple Brandon S. Gettleman Andrew Duong Matthew Chen Jennifer C. Wang Nathanael D. Heckmann Lawrence Menendez |
| author_sort | Alexander B. Christ |
| collection | DOAJ |
| description | Aims: The modern prevalence of primary tumours causing metastatic bone disease is ill-defined in the oncological literature. Therefore, the purpose of this study is to identify the prevalence of primary tumours in the setting of metastatic bone disease, as well as reported rates of pathological fracture, postoperative complications, 90-day mortality, and 360-day mortality for each primary tumour subtype. Methods: The Premier Healthcare Database was queried to identify all patients who were diagnosed with metastatic bone disease from January 2015 to December 2020. The prevalence of all primary tumour subtypes was tabulated. Rates of long bone pathological fracture, 90-day mortality, and 360-day mortality following surgical treatment of pathological fracture were assessed for each primary tumour subtype. Patient characteristics and postoperative outcomes were analyzed based upon whether patients had impending fractures treated prophylactically versus treated completed fractures. Results: In total, 407,893 unique patients with metastatic bone disease were identified. Of the 14 primary tumours assessed, metastatic bone disease most frequently originated from lung (24.8%), prostatic (19.4%), breast (19.3%), gastrointestinal (9.4%), and urological (6.5%) malignancies. The top five malignant tumours resulting in long bone pathological fracture were renal (5.8%), myeloma (3.4%), female reproductive (3.2%), lung (2.8%), and breast (2.7%). Following treatment of pathological fractures of long bones, 90-day mortality rates were greatest for lung (12.1%), central nervous system (10.5%), lymphoma (10.4%), gastrointestinal (10.1%), and non-renal urinary (10.0%) malignancies. Finally, our study demonstrates improved 90-day and 360-day survival in patients treated for impending pathological fracture compared to completed fracture, as well as significantly lower rates of deep vein thrombosis, pulmonary embolism, urinary tract infection, and blood transfusion. Conclusion: This study defines the contemporary characteristics of primary malignancies resulting in metastatic bone disease. These data should be considered by surgeons when prognosticating patient outcomes during treatment of their metastatic bone disease. Cite this article: Bone Jt Open 2023;4(6):424–431. |
| first_indexed | 2024-03-13T02:54:21Z |
| format | Article |
| id | doaj.art-44bfbeb2dfff45ccb46fe217eb527205 |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-03-13T02:54:21Z |
| publishDate | 2023-06-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj.art-44bfbeb2dfff45ccb46fe217eb5272052023-06-28T07:32:47ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622023-06-014642443110.1302/2633-1462.46.BJO-2023-0042.R1Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone diseaseAlexander B. Christ0Amit S. Piple1Brandon S. Gettleman2Andrew Duong3Matthew Chen4Jennifer C. Wang5Nathanael D. Heckmann6Lawrence Menendez7Keck School of Medicine of USC, Los Angeles, California, USAKeck School of Medicine of USC, Los Angeles, California, USASchool of Medicine, University of South Carolina, Columbia, South Carolina, USAKeck School of Medicine of USC, Los Angeles, California, USAKeck School of Medicine of USC, Los Angeles, California, USAKeck School of Medicine of USC, Los Angeles, California, USAKeck School of Medicine of USC, Los Angeles, California, USAKeck School of Medicine of USC, Los Angeles, California, USAAims: The modern prevalence of primary tumours causing metastatic bone disease is ill-defined in the oncological literature. Therefore, the purpose of this study is to identify the prevalence of primary tumours in the setting of metastatic bone disease, as well as reported rates of pathological fracture, postoperative complications, 90-day mortality, and 360-day mortality for each primary tumour subtype. Methods: The Premier Healthcare Database was queried to identify all patients who were diagnosed with metastatic bone disease from January 2015 to December 2020. The prevalence of all primary tumour subtypes was tabulated. Rates of long bone pathological fracture, 90-day mortality, and 360-day mortality following surgical treatment of pathological fracture were assessed for each primary tumour subtype. Patient characteristics and postoperative outcomes were analyzed based upon whether patients had impending fractures treated prophylactically versus treated completed fractures. Results: In total, 407,893 unique patients with metastatic bone disease were identified. Of the 14 primary tumours assessed, metastatic bone disease most frequently originated from lung (24.8%), prostatic (19.4%), breast (19.3%), gastrointestinal (9.4%), and urological (6.5%) malignancies. The top five malignant tumours resulting in long bone pathological fracture were renal (5.8%), myeloma (3.4%), female reproductive (3.2%), lung (2.8%), and breast (2.7%). Following treatment of pathological fractures of long bones, 90-day mortality rates were greatest for lung (12.1%), central nervous system (10.5%), lymphoma (10.4%), gastrointestinal (10.1%), and non-renal urinary (10.0%) malignancies. Finally, our study demonstrates improved 90-day and 360-day survival in patients treated for impending pathological fracture compared to completed fracture, as well as significantly lower rates of deep vein thrombosis, pulmonary embolism, urinary tract infection, and blood transfusion. Conclusion: This study defines the contemporary characteristics of primary malignancies resulting in metastatic bone disease. These data should be considered by surgeons when prognosticating patient outcomes during treatment of their metastatic bone disease. Cite this article: Bone Jt Open 2023;4(6):424–431.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.46.BJO-2023-0042.R1bone metastasisprevalencepathological fracturemortalitymalignancypathological fracturesmalignant neoplasmmetastatic disease of the boneimpending fracturesimpending pathological fracturesdeep vein thrombosis (dvt)fracture of the long bonessurgical treatmentlong bonepostoperative complications |
| spellingShingle | Alexander B. Christ Amit S. Piple Brandon S. Gettleman Andrew Duong Matthew Chen Jennifer C. Wang Nathanael D. Heckmann Lawrence Menendez Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone disease Bone & Joint Open bone metastasis prevalence pathological fracture mortality malignancy pathological fractures malignant neoplasm metastatic disease of the bone impending fractures impending pathological fractures deep vein thrombosis (dvt) fracture of the long bones surgical treatment long bone postoperative complications |
| title | Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone disease |
| title_full | Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone disease |
| title_fullStr | Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone disease |
| title_full_unstemmed | Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone disease |
| title_short | Prevalence of primary malignant tumours, rates of pathological fracture, and mortality in the setting of metastatic bone disease |
| title_sort | prevalence of primary malignant tumours rates of pathological fracture and mortality in the setting of metastatic bone disease |
| topic | bone metastasis prevalence pathological fracture mortality malignancy pathological fractures malignant neoplasm metastatic disease of the bone impending fractures impending pathological fractures deep vein thrombosis (dvt) fracture of the long bones surgical treatment long bone postoperative complications |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.46.BJO-2023-0042.R1 |
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