Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis
Background: Megaprosthetic reconstruction is sometimes indicated in advanced metastatic bone disease (MBD) of the appendicular skeleton with large degrees of bone loss or need for oncological segmental resection. Outcome after megaprosthetic reconstruction was studied in the setting of primary bone...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/5/279 |
| _version_ | 1797500520683798528 |
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| author | Joachim Thorkildsen Thale Asp Strøm Nils Jørgen Strøm Simen Sellevold Ole-Jacob Norum |
| author_facet | Joachim Thorkildsen Thale Asp Strøm Nils Jørgen Strøm Simen Sellevold Ole-Jacob Norum |
| author_sort | Joachim Thorkildsen |
| collection | DOAJ |
| description | Background: Megaprosthetic reconstruction is sometimes indicated in advanced metastatic bone disease (MBD) of the appendicular skeleton with large degrees of bone loss or need for oncological segmental resection. Outcome after megaprosthetic reconstruction was studied in the setting of primary bone sarcoma with high levels of complications, but it is not known if this applies to MBD. Method: We performed a comparative analysis of complications and revision surgery for MBD and bone sarcoma surgery in an institutional cohort from 2005–2019. Presented are the descriptive data of the cohort, with Kaplan–Meier (K–M) rates of revision at 1, 2 and 5 years together with a competing risk analysis by indication type. Results: Rates of revision surgery are significantly lower for MBD (8% at 1 year, 12% at 2 years), in the intermediate term, compared to that of sarcoma (18% at 1 year, 24% at 2 years) (<i>p</i> = 0.04). At 5 years this is not significant by K–M analysis (25% for MBD, and 33% for sarcoma), but remains significant in a competing risk model (8% for MBD, and 20% for sarcoma) (<i>p</i> = 0.03), accounting for death as a competing event. Conclusion: Rates of revision surgery after megaprosthetic reconstruction of MBD are significantly lower than that for primary bone sarcoma in this cohort. |
| first_indexed | 2024-03-10T03:04:01Z |
| format | Article |
| id | doaj.art-971a6c3dd7ba40608310250c305a6809 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T03:04:01Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-971a6c3dd7ba40608310250c305a68092023-11-23T10:37:12ZengMDPI AGCurrent Oncology1198-00521718-77292022-05-012953460347110.3390/curroncol29050279Megaprosthesis for Metastatic Bone Disease—A Comparative AnalysisJoachim Thorkildsen0Thale Asp Strøm1Nils Jørgen Strøm2Simen Sellevold3Ole-Jacob Norum4Division of Orthopaedic Surgery, Oslo University Hospital, 0424 Oslo, NorwayDivision of Orthopaedic Surgery, Oslo University Hospital, 0424 Oslo, NorwayFaculty of Law, University of Oslo, 0315 Oslo, NorwayDivision of Orthopaedic Surgery, Oslo University Hospital, 0424 Oslo, NorwayDivision of Orthopaedic Surgery, Oslo University Hospital, 0424 Oslo, NorwayBackground: Megaprosthetic reconstruction is sometimes indicated in advanced metastatic bone disease (MBD) of the appendicular skeleton with large degrees of bone loss or need for oncological segmental resection. Outcome after megaprosthetic reconstruction was studied in the setting of primary bone sarcoma with high levels of complications, but it is not known if this applies to MBD. Method: We performed a comparative analysis of complications and revision surgery for MBD and bone sarcoma surgery in an institutional cohort from 2005–2019. Presented are the descriptive data of the cohort, with Kaplan–Meier (K–M) rates of revision at 1, 2 and 5 years together with a competing risk analysis by indication type. Results: Rates of revision surgery are significantly lower for MBD (8% at 1 year, 12% at 2 years), in the intermediate term, compared to that of sarcoma (18% at 1 year, 24% at 2 years) (<i>p</i> = 0.04). At 5 years this is not significant by K–M analysis (25% for MBD, and 33% for sarcoma), but remains significant in a competing risk model (8% for MBD, and 20% for sarcoma) (<i>p</i> = 0.03), accounting for death as a competing event. Conclusion: Rates of revision surgery after megaprosthetic reconstruction of MBD are significantly lower than that for primary bone sarcoma in this cohort.https://www.mdpi.com/1718-7729/29/5/279megaprosthesismetastatic bone diseasesurgerycomplicationsrevisionsarcoma |
| spellingShingle | Joachim Thorkildsen Thale Asp Strøm Nils Jørgen Strøm Simen Sellevold Ole-Jacob Norum Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis Current Oncology megaprosthesis metastatic bone disease surgery complications revision sarcoma |
| title | Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis |
| title_full | Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis |
| title_fullStr | Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis |
| title_full_unstemmed | Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis |
| title_short | Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis |
| title_sort | megaprosthesis for metastatic bone disease a comparative analysis |
| topic | megaprosthesis metastatic bone disease surgery complications revision sarcoma |
| url | https://www.mdpi.com/1718-7729/29/5/279 |
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