Abstract
A retrospective study of 20 patients with 21 metastatic bone tumors of the proximal femur was conducted to compare surgical data, pain-relief, functional recovery, and the rate of survival. The patients were divided into two groups, patients who underwent either a wide excision and reconstruction by endoprosthetic replacement (group 1), or an intralesional excision and internal fixation supplemented by methylmetacrylate (group 2). 9 patients in group 1 had metastases from primary tumors in the following locations: kindney (3), prostate (2), lung (2), etc., and 11 patients in group 2 had: lung (4), multiple myeloma (3), breast (2), etc.
The average blood loss was 696g in group 1 and 1190g in group 2, and the average surgical time was 238 minutes in group 1 and 133 minutes in group 2. Pain relief was classified as excellent or good in most cases (95%). All the cases in group 1 were classified as excellent with regard to the ability to walk postoperatively, while only 58% of the patients in group 2 were classified as excellent or good. Furthermore, the prognosis for the survival of the patients in group 1 was considerably superior to that of the patients in group 2. These results revealed that the surgical invasiveness was almost equal between the two groups and that the patients in group 1 exceeded those in group 2 in terms of pain-relief, function, and the rate of survival.
The results confirmed that patients should be treated by wide excision of the metastatic tumor and reconstruction by endoprosthetic replacement for long-term survival.
