Groundland John, Tokson Jacqueline Hart, Hakim Anne, Cizik Amy, Blank Alan, Lerman Daniel, Jones Kevin, Randall R Lor
Department of Orthopedic Surgery, University of Utah, Salt Lake City, Utah, USA.
Department of Orthopedic Surgery, Rush University, Chicago, Illinois, USA.
J Surg Oncol. 2025 Apr;131(5):955-964. doi: 10.1002/jso.27932. Epub 2024 Nov 28.
Currently, there is a paucity of data that describes the length of time required to realize improvement in pain and function following surgery for patients with metastatic cancer to bone.
One hundred patients with impending or completed pathologic fractures due to metastatic cancer to bone were enrolled in this prospective cohort study. Outcomes were measured with a Computer Adaptive Test of Patient Reported Outcomes for Pain Interference and Physical Function domains, to determine the time required to achieve a Minimal Clinically Important Difference (MCID) in the tested domains.
Eighty-one patients were included in the analysis. Thirty-two patients (39.5%) survived and completed the follow-up to 1 year, while 23 (28.4%) died before the end of the data collection. Fifty-one patients (63.0%) achieved at least a 5-point improvement in Physical Function and 59 (72.8%) achieved at least a 5-point improvement in Pain Interference. The time to achieve the MCID was 6 weeks for the Physical Function and 4 weeks for the Pain Interference domain.
The majority of patients with impending or completed pathologic fractures due to metastatic cancer see clinically important improvements in pain and function after surgery in an average of 4 and 6 weeks, respectively.
目前，关于骨转移癌患者术后疼痛和功能改善所需时间的数据匮乏。
本前瞻性队列研究纳入了100例因骨转移癌导致即将发生或已发生病理性骨折的患者。采用患者报告结局的计算机自适应测试来测量疼痛干扰和身体功能领域的结果，以确定在测试领域中达到最小临床重要差异（MCID）所需的时间。
81例患者纳入分析。32例患者（39.5%）存活并完成了1年的随访，23例（28.4%）在数据收集结束前死亡。51例患者（63.0%）身体功能至少改善了5分，59例（72.8%）疼痛干扰至少改善了5分。身体功能领域达到MCID的时间为6周，疼痛干扰领域为4周。
大多数因骨转移癌导致即将发生或已发生病理性骨折的患者，术后疼痛和功能在平均4周和6周后出现临床上的重要改善。
