| 1. |
- Hansen, Bjarne H, et al.
(författare)
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The Scandinavian Sarcoma Group Skeletal Metastasis Registry Functional outcome and pain after surgery for bone metastases in the pelvis and extremities
- 2009
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Ingår i: ACTA ORTHOPAEDICA. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 80, s. 85-90
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Tidskriftsartikel (refereegranskat)abstract
- Background Few authors have investigated function and pain after surgical treatment of patients with bone metastases. In 1999 the Scandinavian Sarcoma Group (SSG) initiated the Skeletal Metastasis Registry as a multi-centric, prospective study to provide a scientific basis for recommendations of treatment. Patients and methods We have analyzed function and pain in 530 patients (mean age 65 yr) operated on (599 operations) for non-spinal skeletal metastases at 9 SSG centres. 7% were operated for more than 1 metastasis. Carcinoma of the breast, prostate, kidney, and lung were the dominating sites for primary tumors. Results 25% of the patients died within 6 weeks after operation. 11% of the patients had complications. 6% had reoperation. In patients surviving more than 1 year the reoperation rate was 12%. 92% of the patients had no, light or moderate pain from metastasis at 6 weeks (first control) and 6 months follow-up. Patients using opioids were reduced from 40% preoperative to 30% at 6 months after surgery. In patients with metastases in pelvis or lower extremity 79% were walking with or without crutches, 6 weeks and 88%, 6 months after surgery. More patients with metastases; in proximal femur were mobile at 6 weeks and 6 months when treated with prosthetic replacement compared to internal fixation. Interpretation Palliative surgery for bone metastases improves function and reduce pain. Mobility is improved by surgery in patients with metastases in the pelvis or lower extremity. Prosthetic replacement seems to do better than internal fixation for metastases in the proximal femur. We need to analyze function and pain earlier than 6 weeks postoperative to investigate the benefit of surgery in patients with short time survival.
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| 2. |
- Minu, Andrew, et al.
(författare)
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Temporal and spatial distribution of trace metals in the Rufiji delta mangrove, Tanzania
- 2018
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Ingår i: Environmental Monitoring & Assessment. - : SPRINGER. - 0167-6369 .- 1573-2959. ; 190:6
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Tidskriftsartikel (refereegranskat)abstract
- Spatial and temporal distribution of trace metals and their cycling is a key issue for understanding the ongoing biogeochemical processes in coastal environments. Sediment cores were collected from six different sampling locations from the Rufiji delta mangrove forests in southeastern coastal Tanzania that are perceived to be impacted by urban development and agricultural activities in the catchment, and pollution in upstream sections of the Rufiji River. The chronology and sediment accumulation rates at these sampling sites were derived based on the distribution of Pb-210(excess) method. The trace metals (As, Cd, Cr, Cu, Ni, Pb, and Zn) were sequentially extracted as per the BCR method and analyzed. The results indicate that the mass accumulation rates range from 0.40 g cm(-2) year(-1) (cores NR3 and NR4) to 1.75 g cm(-2) year(-1) (core SR1). Trace metals in the cores are mainly associated with the residual phase and their abundances in sediments are ranked as Cr amp;gt; Zn amp;gt; Ni amp;gt; Cu amp;gt; Pb amp;gt; Cd. The results imply that trace metals in the Rufiji delta mangroves are mainly of crustal origin, and they are less sensitive to weathering. Further, these metals are least available for uptake by plants and they pose limited threat to the biota.
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| 3. |
- Ratasvuori, Maire, et al.
(författare)
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Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis
- 2013
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Ingår i: Surgical Oncology. - : Elsevier BV. - 0960-7404 .- 1879-3320. ; 22:2, s. 132-138
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Forskningsöversikt (refereegranskat)abstract
- The number of cancer patients living with metastatic disease is growing. The increased survival has led to an increase in the number of cancer-induced complications, such as pathologic fractures due to bone metastases. Surgery is most commonly needed for mechanical complications, such as fractures and intractable pain. We determined survival, disease free interval and complications in surgically treated bone metastasis. Data were collected from the Scandinavian Skeletal Metastasis Registry for patients with extremity skeletal metastases surgically treated at eight major Scandinavian referral centres between 1999 and 2009 covering a total of 1195 skeletal metastases in 1107 patients. Primary breast, prostate, renal, lung, and myeloma tumors make up 78% of the tumors. Number of complications is tolerable and is affected by methods of surgery as well as preoperative radiation therapy. Overall 1-year patient survival was 36%; however, mean survival was influenced by the primary tumor type and the presence of additional visceral metastases. Patients with impending fracture had more systemic complications than those with complete fracture. Although surgery is usually only a palliative treatment, patients can survive for years after surgery. We developed a simple, useful and reliable scoring system to predict survival among these patients. This scoring system gives good aid in predicting the prognosis when selecting the surgical method. While it is important to avoid unnecessary operations, operating when necessary can provide benefit. (C) 2013 Elsevier Ltd. All rights reserved.
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| 4. |
- Ratasvuori, Maire, et al.
(författare)
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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
- 2014
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Ingår i: Journal of Surgical Oncology. - : Wiley-Blackwell. - 0022-4790 .- 1096-9098. ; 110:4, s. 360-365
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives In metastatic disease, decisions regarding potential surgery require reliable data about the patients 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. J. Surg. Oncol. 2014; 110:360-365.
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| 5. |
- Wedin, Rikard, et al.
(författare)
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Complications and survival after surgical treatment of 214 metastatic lesions of the humerus
- 2012
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Ingår i: Journal of Shoulder and Elbow Surgery. - : Elsevier BV. - 1058-2746 .- 1532-6500. ; 21:8, s. 1049-1055
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Tidskriftsartikel (refereegranskat)abstract
- Background: The humerus is the second most common long-bone site of metastatic bone disease. We report complications, risk factors for failure, and survival of a large series of patients operated on for skeletal metastases of the humerus. Materials and methods: This study was based on 208 patients treated surgically for 214 metastatic lesions of the humerus. Reconstructions were achieved by intramedullary nails in 148, endoprostheses in 35, plate fixation in 21, and by other methods in 10. Results: The median age at surgery was 67 years (range, 29-87 years). Breast cancer was the primary tumor in 31%. The overall failure rate of the surgical reconstructions was 9%. The reoperation rate was 7% in the proximal humerus, 8% in the diaphysis, and 33% in the distal part of the bone. Among 36 operations involving an endoprosthesis, 2 were failures (6%) compared with 18 of 178 osteosynthetic devices (10%). In the osteosynthesis group, intramedullary nails failed in 7% and plate fixation failed in 22%. Multivariate Cox regression analysis showed that prostate cancer was associated with an increased risk of failure after surgery (hazard ratio, 7; P < 0.033). The cumulative survival after surgery was 40% (95% confidence interval [CI] 34-47) at 1 year, 21% (95% CI, 15-26) at 2 years, and 16% (95% CI, 12-19) at 3 years. Conclusions: Our method of choice is the cemented hemiprosthesis for pathologic proximal humeral fractures and interlocked intramedullary nail for lesions in the diaphysis. Pathologic fractures in the distal humerus are uncommon and associated with a very high reoperation rate. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.
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