Efficacy of limb salvage with primary tumor resection simultaneously for solitary bone metastasis in limbs

Abstract

Background

This study aims to evaluate the efficacy of limb salvage with primary tumor resection on patients with solitary bone metastasis.

Methods

A retrospective treatment outcome review was performed on 20 patients with solitary bone metastasis as the primary clinical symptom who were admitted to the hospital between 2006 and 2010. With primary tumor resection, 18/20 patients received limb salvage surgery simultaneously. Pain scoring was assessed using the 0 to 10 numerical rating scale. The quality of life scoring was performed before and 3 months after surgery using the SF-30 scoring system. In addition, limb function was assessed 3 months after the operation using the Scoring System of American Musculoskeletal Tumor Society system (MSTS).

Results

The pain symptom was significantly ameliorated after the operation (t = 26.653, P < 0.001), and the quality of life dramatically improved (t = −20.581, P < 0.001). The postoperative MSTS scores ranged from 18 to 27. The average score was 23.10 ± 2.36. The Kaplan-Meier analysis showed that no significant differences (χ2 = 1.589, P = 0.207) were observed in the tumor-free survival time between the wide and marginal resections.

Conclusions

The application of the wide or marginal excision for the primary lesion and bony metastasis focus, based on the principles of primary bone tumors, can significantly relieve the pain and improve the quality of life and limb function of patients whose solitary bone metastasis was manifested as the first sign.

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