title: Prognostic role of en-bloc resection and late onset of bone metastasis in patients with bone-seeking carcinomas of the kidney, breast, lung, and prostate: SSG study on 672 operated skeletal metastases.
abstract: OBJECTIVE
  In metastatic disease, decisions regarding potential surgery require reliable data about the patient's survival. In this study, we evaluated different prognostic factors and their impact in four common primary tumors causing bone metastases.
  
  
  METHODS
  Data were acquired from the Scandinavian Sarcoma Group (SSG) metastasis registry. The patients underwent surgery between July 1999 and July 2009. This study included breast, prostate, lung, and kidney cancer cases, with a total of 672 operated non-spinal metastases. Differences in prognostic factors were evaluated using the Kaplan-Meier method with long-rank test. Cox regression multivariate analysis was performed to identify statistically independent prognostic factors.
  
  
  RESULTS
  Significant factors affecting survival were the presence of organ metastases, overall heath status, and disease load. In kidney cancer, en bloc resection of solitary metastases was associated with a significant fourfold longer survival compared to intralesional surgery. Preoperative radiotherapy was associated with higher complication and reoperation rates.
  
  
  CONCLUSIONS
  This data summary is important tool for clinicians to evaluate survival and choose treatment options for patients suffering from metastatic bone disease.
authors.affiliation: Departement of Surgery, South Karelian Central Hospital, Lappeenranta, Finland; Department of Orthopedics, Unit of Musculoskeletal Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Maire
authors.initials: M
authors.lastname: Ratasvuori
authors.forename: Rikard
authors.initials: R
authors.lastname: Wedin
authors.forename: Bjarne H
authors.initials: BH
authors.lastname: Hansen
authors.forename: Johnny
authors.initials: J
authors.lastname: Keller
authors.forename: Clement
authors.initials: C
authors.lastname: Trovik
authors.forename: Olga
authors.initials: O
authors.lastname: Zaikova
authors.forename: Peter
authors.initials: P
authors.lastname: Bergh
authors.forename: Anders
authors.initials: A
authors.lastname: Kalen
authors.forename: Minna
authors.initials: M
authors.lastname: Laitinen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000473:pathology*
keywords: bone metastases; prognostic factors; surgical treatment