title: Skeletal metastases in 301 breast cancer patients: patient survival and complications after surgery.
abstract: The aim was to identify prognostic variables associated with survival in 301 breast cancer patients after surgical treatment of skeletal metastases. The study period was 1986-2012. The median age at surgery was 61 (interquartile-range [IQR] 52-70) years. The cumulative 1-, 2-, and 5-year survival after surgery was 45% (95% CI 39-51), 27% (22-32), and 8% (5-12), respectively. The median follow-up time was 1 (IQR 0.2-2) year. Age over 60 years (Hazard ratio [HR] 1.9) and hemoglobin levels <110 g/L (HR 2) increased the risk of death after surgery. Patients with impending fractures (HR 0.4) had a lower death rate. The overall neurological function in patients with spinal metastases improved after surgery (p < 0.001). The complication rate was 25%, including 14% re-operations. Survival data and analysis of complications of this large cohort of surgically treated breast cancer patients help to set appropriate expectations for the patients, families, and medical staff.
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden. Electronic address: rudiger.weiss@karolinska.se.
authors.forename: Rüdiger J
authors.initials: RJ
authors.lastname: Weiss
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden.
authors.forename: Elias
authors.initials: E
authors.lastname: Tullberg
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Forsberg
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden.
authors.forename: Henrik C
authors.initials: HC
authors.lastname: Bauer
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden.
authors.forename: Rikard
authors.initials: R
authors.lastname: Wedin
mesh_terms: D000367:Age Factors; D001859:Bone Neoplasms / Q000150:complications / Q000401:mortality / Q000556:secondary / Q000601:surgery; D001943:Breast Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology / Q000209:etiology; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008017:Life Expectancy; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology
chemical_list: D006454:Hemoglobins
keywords: Breast cancer; Complication; Outcome; Re-operation; Skeletal metastases; Surgery