[Palliative surgical treatment of bone metastases. Improved quality of life by early intervention?]

Abstract

Objective: To find out to what extent early operative treatment of osteolysis or pathological fractures, resulting from improved interdisciplinary treatment of malignant tumours, affects quality of life.

Patients and method: Using a standardised scheme of self-evaluation in a retrospective study, quality of life was assessed in 67 patients (18 men, 49 women; mean age 64.5 +/- 11.6 years) who were operated for osteolyses or pathological limb fractures due to malignant tumour metastases.

Results: Interlocking osteosynthesis was performed in 37 patients, endoprosthetic joint replacement in 30. Duration of operation and hospital stay were significantly shorter in those 17 patients operated for osteolysis than those 50 patients with a pathological fracture (P < 0.01 and P < 0.07, respectively). There were seven hospital deaths. Postoperative survival time averaged 13.4 months. 41 of the 60 patients discharged to outpatient follow-up were again capable of leading a normal life, 13 were clearly impaired, six required nursing care, 46 patients did not or only sporadically require analgesics postoperatively.

Conclusion: Early operative treatment of osteolysis before the occurrence of fractures is justified by the low operative mortality and complication rates and the better quality of life that is achieved.