title: Metastases to the hand and wrist: an analysis of 221 cases.
abstract: OBJECTIVE
  To identify demographic trends, survival rates, the most common metastatic locations, and the most common primary malignant tumors in the reports of hand and wrist metastases published over the past 27 years.
  
  
  METHODS
  A keyword search was performed across PubMed, Google, Science Direct, and Springer databases with a time-range restriction set between April 1986 and April 2013. A total of 193 articles were located describing 221 patients. The data were analyzed for patient age, sex, known history of malignancy, primary tumor site, histological diagnosis, metastatic location, hand involvement, and survival rates.
  
  
  RESULTS
  Lung, gastrointestinal tract, and kidney malignancies were the 3 leading metastatic tumors. The mean age among patients was 61 ± 13 years, and involvement among men was almost twice as common as among women. The mean survival from the time of the diagnosis was 7 ± 7 months. There were no predilections for either the right or the left hand. The distal phalanx was the most frequently involved bone, and the thumb was the most frequently involved digit.
  
  
  CONCLUSIONS
  The frequency of published hand and wrist metastasis has increased dramatically within the last decade. Metastases have been reported for every bone of the hand and wrist as well as for the soft tissues. Compared with the previous studies, the mean age of reported patients has slightly increased even though the mean survival time has not changed.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran; Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran; University of Montreal, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada. Electronic address: afshar_ah@yahoo.com.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Afshar
authors.affiliation: Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran; Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran; University of Montreal, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada.
authors.forename: Payam
authors.initials: P
authors.lastname: Farhadnia
authors.affiliation: Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran; Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran; University of Montreal, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Khalkhali
mesh_terms: D001859:Bone Neoplasms / Q000453:epidemiology / Q000556:secondary*; D005260:Female; D006225:Hand; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000453:epidemiology / Q000556:secondary*; D015996:Survival Rate; D014953:Wrist
keywords: Acrometastasis; carpal metastasis; hand metastasis; wrist metastasis