Department of Orthopaedics, E-Da Hospital, Kaohsiung, Taiwan.
School of Medicine, I-Shou University, Kaohsiung, Taiwan.
BMC Cancer. 2018 Jun 4;18(1):628. doi: 10.1186/s12885-018-4329-2.
Knowledge on periprosthetic infection and mortality rate following total knee arthroplasty (TKA) is essential for justifying this treatment in patients with cancer; however, relevant data from population-based studies are lacking. Therefore, we examined 1-year periprosthetic infection, mortality, and 5-year relative survival rates in cancer patients who underwent TKA.
This is a population-based cohort study based on analysis of the Taiwan National Health Insurance Research Database. We enrolled a total of 2294 cancer patients and 131,849 patients without cancer (control group) who underwent TKA between January 1, 1997, and December 31, 2011. All patients were followed until death, infection, withdrawal from the National Health Insurance, or December 31, 2012.
The periprosthetic knee joint infection rate in cancer patients (1.73%) was not significantly higher than that in the control group (1.87%). However, the 1-year mortality rate was significantly higher (p < 0.05) in the cancer group (4.10%) than in the control group (1.66%). The overall 5-year survival rate was 93.10% as compared with those without cancers.
Low periprosthetic knee joint infection rates and high 5-year relative survival rates indicate the feasibility of TKA in cancer patients. However, the surgeon should take into account a higher mortality rate in the first year following TKA.
了解全膝关节置换术（TKA）后假体周围感染和死亡率对于在癌症患者中证明这种治疗方法的合理性至关重要；然而，缺乏基于人群的研究相关数据。因此，我们研究了接受 TKA 的癌症患者的 1 年假体周围感染、死亡率和 5 年相对生存率。
这是一项基于对台湾全民健康保险研究数据库分析的基于人群的队列研究。我们共纳入了 2294 名癌症患者和 131849 名未患癌症的患者（对照组），他们在 1997 年 1 月 1 日至 2011 年 12 月 31 日期间接受了 TKA。所有患者均随访至死亡、感染、退出全民健康保险或 2012 年 12 月 31 日。
癌症患者（1.73%）的假体周围膝关节感染率与对照组（1.87%）相比无显著差异。然而，癌症组的 1 年死亡率（4.10%）明显高于对照组（1.66%）（p<0.05）。总体 5 年生存率为 93.10%，与未患癌症者相当。
低假体周围膝关节感染率和高 5 年相对生存率表明 TKA 在癌症患者中是可行的。然而，外科医生应考虑到 TKA 后第一年的死亡率较高。
