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骨科医生对骨转移瘤的诊断与外科治疗趋势

Trends in Diagnosis and Surgical Treatment of Bone Metastases among Orthopedic Surgeons.

作者信息

Ciechanowicz Dawid, Kotrych Daniel, Dąbrowski Filip, Mazurek Tomasz

机构信息

Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland.

Department of Orthopaedics, Traumatology and Orthopaedic Oncology, Collegium Medicum University in Zielona Gora, 65-046 Zielona Gora, Poland.

出版信息

J Clin Med. 2022 Jul 23;11(15):4284. doi: 10.3390/jcm11154284.

DOI:10.3390/jcm11154284
PMID:35893375
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9341391/
Abstract

BACKGROUND

The proper diagnosis and treatment of bone metastases are essential for patient survival. However, several strategies for the treatment are practiced. Therefore, the aim of the study was to analyze what factors influence the choice of a method of treatment.

METHODS

An online survey was conducted within the Polish Society of Orthopedics and Traumatology. It consisted of 45 questions and was divided into four main parts: Participant Characteristics, Diagnosis and Qualification, Treatment, and Clinical Cases.

RESULTS

A total number of 104 responses were collected. The most frequently chosen methods were: Intramedullary nail (IMN) + Resection + Polymethyl methacrylate (PMMA) (30.47%) and IMN without tumor resection (42.13%), and in third place, modular endoprosthesis (17.25%). The less experienced group of orthopedic surgeons more often (47.5% vs. 39.5%) decided to perform IMN without tumor resection than the more experienced group ( = 0.046). Surgeons from district hospitals less frequently (13.7% vs. 23.1%) would decide to use modular endoprosthesis than surgeons from university hospitals ( = 0.000076). Orthopedists who performed ≥ 11 bone metastases surgeries per year would more often use modular endoprosthesis (34.8% vs. 13.2%) than those who performed ≤ 10 operations per year ( = 0.000114).

CONCLUSION

Experience, place of work, and the number of metastasis surgeries performed during a year may influence the choice of treatment method in patients with bone metastases.

摘要

背景

骨转移瘤的正确诊断和治疗对患者的生存至关重要。然而,目前存在多种治疗策略。因此,本研究的目的是分析哪些因素会影响治疗方法的选择。

方法

在波兰骨科学与创伤外科学会内部进行了一项在线调查。该调查包含45个问题,分为四个主要部分:参与者特征、诊断与资格评估、治疗以及临床病例。

结果

共收集到104份回复。最常被选择的方法是:髓内钉(IMN)+切除术+聚甲基丙烯酸甲酯(PMMA)(30.47%)和不进行肿瘤切除的IMN(42.13%),排在第三位的是模块化假体(17.25%)。经验较少的骨科医生组比经验丰富的组更常(47.5%对39.5%)决定不进行肿瘤切除而实施IMN(P = 0.046)。与大学医院的外科医生相比,地区医院的外科医生决定使用模块化假体的频率更低(13.7%对23.1%)(P = 0.000076)。每年进行≥11例骨转移瘤手术的骨科医生比每年进行≤10例手术的医生更常使用模块化假体(34.8%对13.2%)(P = 0.000114)。

结论

经验、工作地点以及一年内进行的转移瘤手术数量可能会影响骨转移瘤患者治疗方法的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/06d637dc62e4/jcm-11-04284-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/15f51c45191d/jcm-11-04284-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/482f18e0e4ed/jcm-11-04284-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/343e15f39327/jcm-11-04284-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/06d637dc62e4/jcm-11-04284-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/15f51c45191d/jcm-11-04284-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/482f18e0e4ed/jcm-11-04284-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/343e15f39327/jcm-11-04284-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ce/9341391/06d637dc62e4/jcm-11-04284-g004.jpg

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