Surgery for skeletal metastases in XXXX .

@entity1 @entity2 @entity15012
BACKGROUND AND PURPOSE: Most @entity2 @entity1 with skeletal metastases have a short survival and it is difficult to identify those @entity1 who will benefit from palliative surgery. We report complication and survival rates in a consecutive series of @entity2 @entity1 who were operated for symptomatic skeletal metastases. METHODS: This study was based on data recorded in the Karolinska Skeletal Metastasis Register. The study period was 1987-2006. We identified 98 @entity2 @entity1 (52 females). The median age at surgery was 62 (34-88) years. 78 lesions were located in the femur or spine. RESULTS: The median survival time after surgery was 3 (0-127) months. The cumulative 12-month survival after surgery was 13% (95% CI: 6-20). There was a difference between the survival after spinal surgery (2 months) and after extremity surgery (4 months) (p = 0.03). Complete pathological fracture in non-spinal metastases (50 @entity1 ) was an independent negative predictor of survival ( @entity15012 , 95% CI: 1-3). 16 of 31 @entity1 with spinal metastases experienced a considerable improvement in their neurological function after surgery. The overall complication rate was 20%, including a reoperation rate of 15%. INTERPRETATION: Bone metastases and their subsequent surgical treatment in @entity2 @entity1 are associated with high morbidity and mortality. Our findings will help to set appropriate expectations for these @entity1 , their families, and surgeons.
