Clara-Altamirano M A, Garcia-Ortega D Y, Martinez-Said H, Caro-Sánchez C H S, Herrera-Gomez A, Cuellar-Hubbe M
Departamento de Piel y Partes Blandas, Instituto Nacional de Cancerología, Ciudad de México, México.
Departamento de Piel y Partes Blandas, Instituto Nacional de Cancerología, Ciudad de México, México.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2018 May-Jun;62(3):185-189. doi: 10.1016/j.recot.2017.12.001. Epub 2018 Mar 21.
Metastatic bone disease is the most common neoplastic process that affects the skeletal system. Eighty percent of bone metastases come from carcinomas of the breast, lung, kidney, thyroid and prostate. The Katagiri scale enables an estimation of the survival of patients based on the presence or absence of visceral metastases, multiple bone metastases and functional status according to the ECOG scale.
A retrospective, descriptive and observational study conducted between March 1, 2013 and June 30, 2015. Thirty-two patients were studied with a diagnosis of metastatic bone disease and who had undergone some type of orthopaedic surgical treatment for pathological fracture or impending fracture.
28 cases (87.5%) presented pathological fracture and 4 cases (12.5%) impending fracture according to the Mirels score. Fifteen cases (46.875%) were treated by placing a central medullary nail + spacer in the long bone diaphysis, 15 cases (46.875%) with modular arthroplasties and 2 patients (6.25%) with forequarter amputation. Eleven patients (34.375%) died during the course of this study, all with a Katagiri greater than or equal to 4.
The presence of a fracture in previously damaged territory is a catastrophic complication for most cancer patients. A clear understanding of the life expectancy of patients with bone metastases is of great help to prevent errors and failures in treatment.
转移性骨病是影响骨骼系统最常见的肿瘤性病变。80%的骨转移瘤来自乳腺癌、肺癌、肾癌、甲状腺癌和前列腺癌。片桐量表能够根据是否存在内脏转移、多发骨转移以及根据东部肿瘤协作组（ECOG）量表评估的功能状态来估计患者的生存期。
一项回顾性、描述性和观察性研究，于2013年3月1日至2015年6月30日进行。对32例诊断为转移性骨病且因病理性骨折或即将发生的骨折接受了某种类型骨科手术治疗的患者进行了研究。
根据米雷尔评分，28例（87.5%）出现病理性骨折，4例（12.5%）为即将发生的骨折。15例（46.875%）患者在长骨干骺端置入中心髓内钉+间隔器进行治疗，15例（46.875%）患者接受模块化关节成形术，2例（6.25%）患者接受上肢截肢术。在本研究过程中，11例（34.375%）患者死亡，所有患者的片桐评分均大于或等于4。
在先前受损部位出现骨折对大多数癌症患者来说是一种灾难性并发症。清楚了解骨转移患者的预期寿命对防止治疗中的错误和失败有很大帮助。
