Surgical management of bone metastases from urological malignancies: an analysis of 70 cases.
OBJECTIVE
The purpose of this study was to evaluate symptomatic bone metastases from urological malignancies and the efficacy of surgical treatment of bone metastases in achieving local tumor control.


METHODS
This was a retrospective observational study of patients diagnosed with bone metastases from urological malignancies who died from their diseases between 2002 and 2013. Data on clinicopathology, number and sites of bone metastasis, time to first and subsequent metastasis, survival after metastasis, nature of metastasis (blastic, mixed, lytic), type of surgical reconstruction, systemic affections, and visceral organ metastasis for 70 bone metastases from deceased urological malignancies patients (55 male, 15 female) with evidence of bone metastasis were statistically analyzed.


RESULTS
Forty-three patients (61.42%) had renal cell carcinoma (RCC), 15 patients (21.43%) had prostate cancer, and 12 patients (17.15%) had bladder carcinoma as primary diagnosis. Osteolytic lesions were most prevalent (n=61; 87%). The most common surgical modality for extremities was wide resection with prosthetic replacement (42 patients), followed by wide resection or wide resection with bone cement application with internal fixation (21 patients); 65 patients were treated with limb salvage procedures, and 2 patients were treated with amputation. Overall median survival was 13 months for RCC, 16 months for prostate carcinoma, and 11 months for bladder carcinoma patients.


CONCLUSIONS
Detection of bone metastases in patients with urological malignancies influences the treatment strategy. Diagnosis of bone metastases may be delayed in urologic malignities; thus, these patients receive long-term clinical follow-up.
Ankara Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey. dr_guray@hotmail.com.
Güray
G
Toğral
Ankara Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
Murat
M
Arıkan
Ankara Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
Erdem
E
Aktaş
Ankara Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
Recep
R
Öztürk
Ankara Oncology Training and Research Hospital, Department of Urology, Ankara, Turkey.
Oğuz
O
Güven
Ankara Oncology Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
Fatih
F
Eksioğlu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology*