Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea.
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Oncologist. 2020 Jan;25(1):e178-e185. doi: 10.1634/theoncologist.2019-0107. Epub 2019 Aug 6.
Postoperative ambulation recovery after surgery for femur metastases has significant implications for not only the patient's quality of life but also administration of further cancer treatment. Thus, identification of preoperative predictors of ambulation recovery is necessary to set appropriate expectations and guide treatment. This study aimed to assess ambulation recovery rate and identify predictors of ambulation recovery in patients undergoing surgery for femur metastases.
A total of 244 patients who underwent surgery for femur metastases at our institution were reviewed. Patients were considered ambulatory if they were able to walk independently or walk with aids and nonambulatory if they were wheelchair bound or bedridden. The following potential clinicopathologic factors that might predict postoperative ambulation recovery were evaluated: premorbid general status, cancer burden, and local factors.
A total of 165 patients (68%) regained ambulatory status postoperatively. A multivariate analysis revealed poor Eastern Cooperative Oncology Group (ECOG) performance status (odds ratio [OR], 5.327; p < .001) and nonambulatory premorbid ambulatory status (OR, 7.459; p < .001) as independent predictors of poor ambulation recovery after surgery for femur metastases. Postoperative ambulatory status was significantly associated with postoperative survival time (p < .001).
Postoperative ambulation recovery rate in our cohort was 68%. Premorbid ambulatory status and ECOG performance status are predictors of ambulation recovery in patients undergoing surgery for femur metastases.
Postoperative ambulation recovery rate in this cohort was 68%. Premorbid ambulatory status and Eastern Cooperative Oncology Group performance status are predictors of ambulation recovery in patients undergoing surgery for femur metastases.
股骨转移瘤手术后的步行康复不仅对患者的生活质量有重要影响，而且对进一步癌症治疗的管理也有重要影响。因此，识别步行康复的术前预测因素对于设定适当的预期和指导治疗是必要的。本研究旨在评估股骨转移瘤患者手术后的步行康复率，并确定步行康复的预测因素。
对我院 244 例行股骨转移瘤手术的患者进行回顾性分析。患者如果能够独立行走或借助辅助器具行走，则被认为是可行走的；如果需要坐轮椅或卧床，则被认为是不可行走的。评估了可能预测术后步行康复的以下潜在临床病理因素：术前一般状况、癌症负担和局部因素。
共有 165 例（68%）患者术后恢复了步行能力。多因素分析显示，东部肿瘤协作组（ECOG）表现状态差（优势比[OR]，5.327；p<0.001）和术前不可行走的状态（OR，7.459；p<0.001）是股骨转移瘤手术后步行康复不良的独立预测因素。术后步行状态与术后生存时间显著相关（p<0.001）。
本研究队列中术后步行康复率为 68%。术前步行状态和 ECOG 表现状态是股骨转移瘤患者手术后步行康复的预测因素。
本研究队列中术后步行康复率为 68%。术前步行状态和 ECOG 表现状态是股骨转移瘤患者手术后步行康复的预测因素。
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