title: Metastatic bone disease: a 36-year single centre trend-analysis of patients admitted to a tertiary orthopaedic surgical department.
abstract: OBJECTIVE
  The treatment and outcome of primary malignant bone tumours has changed with the advances in diagnostic and treatment modalities. A trend-analysis on a large cohort of patients with metastatic bone disease was performed.
  
  
  METHODS
  A retrospective chart review of all cases with metastatic bone disease admitted to a single tertiary orthopaedic referral centre, registered with the Vienna Bone and Soft Tissue Tumour Registry between 1968 and 2003 was conducted. For trend-analysis of frequency, survival, primary site, treatment methods, and others, the 36-year study duration was divided into four periods.
  
  
  RESULTS
  The study identified 601 females and 580 males (mean: 60 years) with metastatic bone disease. The most common metastases were secondary to breast cancer (n = 275; 23%) and renal cell carcinoma (n = 242; 21%) and the majority were located in the femur (n = 332; 28%) and spine (n = 348; 29%). Overall, the proportion of patients who underwent surgery decreased. At follow-up, 887 (75%) patients were verified to have died of their disease.
  
  
  CONCLUSIONS
  Over the 36-year period, the frequency of bone metastases has increased at our centre. Although survival increased over time, the difference was not significant; this was most likely attributable to the seriousness of cases referred to our tertiary care centre.
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Vienna, Vienna, Austria. cyril.toma@meduniwien.ac.at
authors.forename: C D
authors.initials: CD
authors.lastname: Toma
authors.forename: M
authors.initials: M
authors.lastname: Dominkus
authors.forename: T
authors.initials: T
authors.lastname: Nedelcu
authors.forename: F
authors.initials: F
authors.lastname: Abdolvahab
authors.forename: O
authors.initials: O
authors.lastname: Assadian
authors.forename: P
authors.initials: P
authors.lastname: Krepler
authors.forename: R
authors.initials: R
authors.lastname: Kotz
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000556:secondary* / Q000628:therapy; D001842:Bone and Bones / Q000473:pathology; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution