Skip to main content

Advertisement

SpringerLink
Log in

Surgical treatment of bone metastases in patients with lung cancer

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Lung cancer is the leading cause of cancer mortality. Bone metastases are a common complication in lung cancer. The therapeutic approach and the type of surgical treatment of these lesions have not been clearly defined. Outcome and prognosis of patients with bony metastases and a variety of surgical interventions were analysed retrospectively. In 58 patients we performed 62 surgeries. The most common locations of metastases were the spine (32 patients), the proximal femur (10) and the pelvis (11). Twenty-one patients had a singular and 20 had multiple osseous lesions; 17 showed additional visceral involvement. Nine patients had a local progression of their disease and 49 a systemic progression. Patients with local progression (n = 9) had a better prognosis than the patients with systemic progression (p = 0.0083). Fracture (p = 0.0017) worsened prognosis, whereas the number of bone lesions or the presence of a visceral lesion did not. Patients with small lesions showed a better survival than patients with large lesions (p = 0.02). Ten percent of the patients died within 30 days and 78% within one year after surgery. Fracture of bone due to metastatic lung cancer worsens the prognosis whereas the number of bone lesions, the presence of a visceral lesion and the surgical approach do not.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics, 2009. CA Cancer J Clin 59:225–249

    Article  PubMed  Google Scholar 

  2. Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12:6243s–6249s

    Article  PubMed  Google Scholar 

  3. Dahlin CC, Unni KK (1986) Bone tumours, 4th edn. Thomas, Springfield

    Google Scholar 

  4. Conroy T, Malissard L, Dartois D, Luporsi E, Stines J, Chardot C (1988) Natural history and development of bone metastasis. Apropos of 429 cases. Bull Cancer 75:845–857

    PubMed  CAS  Google Scholar 

  5. Hanagiri T, Kodate M, Nagashima A, Sugaya M, Dobashi K, Ono M et al (2000) Bone metastasis after a resection of stage I and II primary lung cancer. Lung Cancer 27:199–204

    Article  PubMed  CAS  Google Scholar 

  6. Higashiyama M, Kodama K, Takami K, Higaki N, Yamada T, Mano M et al (2004) Surgical treatment of bone metastasis followed by a primary lung cancer lesion: report of a case. Surg Today 34:600–605

    Article  PubMed  Google Scholar 

  7. Katagiri H, Takahashi M, Inagaki J, Sugiura H, Ito S, Iwata H (1999) Determining the site of the primary cancer in patients with skeletal metastasis of unknown origin: a retrospective study. Cancer 86:533–537

    Article  PubMed  CAS  Google Scholar 

  8. Erturan S, Yaman M, Aydin G, Uzel I, Musellim B, Kaynak K (2005) The role of whole-body bone scanning and clinical factors in detecting bone metastases in patients with non-small cell lung cancer. Chest 127:449–454

    Article  PubMed  Google Scholar 

  9. Salvatierra A, Baamonde C, Llamas JM, Cruz F, Lopez-Pujol J (1990) Extrathoracic staging of bronchogenic carcinoma. Chest 97:1052–1058

    Article  PubMed  CAS  Google Scholar 

  10. Lally BE, Urbanic JJ, Blackstock AW, Miller AA, Perry MC (2007) Small cell lung cancer: have we made any progress over the last 25 years? Oncologist 12:1096–1104

    Article  PubMed  Google Scholar 

  11. Wedin R, Bauer HC, Wersall P (1999) Failures after operation for skeletal metastatic lesions of long bones. Clin Orthop Relat Res 358:128–139

    Article  PubMed  Google Scholar 

  12. Capanna R, Campanacci DA (2001) The treatment of metastases in the appendicular skeleton. J Bone Joint Surg Br 83:471–481

    Article  PubMed  CAS  Google Scholar 

  13. Granville CA, Dennis PA (2005) An overview of lung cancer genomics and proteomics. Am J Respir Cell Mol Biol 32:169–176

    Article  PubMed  CAS  Google Scholar 

  14. Mercadante S (1997) Malignant bone pain: pathophysiology and treatment. Pain 69:1–18

    Article  PubMed  CAS  Google Scholar 

  15. Mundy GR (1997) Mechanisms of bone metastasis. Cancer 80(8 Suppl):1546–1556

    Article  PubMed  CAS  Google Scholar 

  16. Stanley KE (1980) Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst 65:25–32

    PubMed  CAS  Google Scholar 

  17. Shih WJ, Magoun S, Lahar B, Stipp V, Gross K (1998) An unusual case of a tibial metastasis as the clinical presentation of bronchogenic adenocarcinoma. J Nucl Med Technol 26:91–93

    PubMed  CAS  Google Scholar 

  18. Hawighorst H, Gademann G (1993) Cure in a patient with multiple osseus metastases in non-small cell lung cancer: a case report. Strahlenther Onkol 169:617–620

    PubMed  CAS  Google Scholar 

  19. Hirano Y, Oda M, Tsunezuka Y, Ishikawa N, Watanabe G (2005) Long-term survival cases of lung cancer presented as solitary bone metastasis. Ann Thorac Cardiovasc Surg 11:401–404

    PubMed  Google Scholar 

  20. Durr HR, Maier M, Pfahler M, Baur A, Refior HJ (1999) Surgical treatment of osseous metastases in patients with renal cell carcinoma. Clin Orthop Relat Res 367:283–290

    PubMed  Google Scholar 

  21. Mountain CF (1987) The new international staging system for lung cancer. Surg Clin N Am 67:925–935

    PubMed  CAS  Google Scholar 

  22. Coleman RE (1997) Skeletal complications of malignancy. Cancer 80(Suppl):1588–1594

    Article  PubMed  CAS  Google Scholar 

  23. Hansen BH, Keller J, Laitinen M, Berg P, Skjeldal S, Trovik C et al (2004) The Scandinavian sarcoma group skeletal metastasis register. Survival after surgery for bone metastases in the pelvis and extremities. Acta Orthop Scand Suppl 75:11–15

    PubMed  CAS  Google Scholar 

  24. Chan D, Carter SR, Grimer RJ, Sneath RS (1992) Endoprosthetic replacement for bony metastases. Ann R Coll Surg Engl 74:13–18

    PubMed  CAS  Google Scholar 

  25. Koizumi K, Haraguchi S, Hirata T, Hirai K, Mikami I, Yamagishi S et al (2004) Surgical treatment of lung cancer with vertebral invasion. Ann Thorac Cardiovasc Surg 10:229–234

    PubMed  Google Scholar 

  26. DeMeester TR, Albertucci M, Dawson PJ, Montner SM (1989) Management of tumor adherent to the vertebral column. J Thorac Cardiovasc Surg 97:373–378

    PubMed  CAS  Google Scholar 

  27. Ginsberg RJ, Martini N, Zaman M, Armstrong JG, Bains MS, Burt ME et al (1994) Influence of surgical resection and brachytherapy in the management of superior sulcus tumor. Ann Thorac Surg 57:1440–1445

    Article  PubMed  CAS  Google Scholar 

  28. Gokaslan ZL, York JE, Walsh GL, McCutcheon IE, Lang FF, Putnam JB Jr et al (1998) Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg 89:599–609

    Article  PubMed  CAS  Google Scholar 

  29. Spaggiari L, Carbognani P, Solli P, Rusca M (1998) Is it justified to ignore oncologic principles during VATS major lung resections? Ann Thorac Surg 66:303–304

    Article  PubMed  CAS  Google Scholar 

  30. Bohm P, Huber J (2002) The surgical treatment of bony metastases of the spine and limbs. J Bone Joint Surg Br 84:521–529

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

We would like to thank Dr. Markus Schlemmer for his support during the linguistic revision.

Conflict of interest statement

All authors disclose any financial or personal relationships with other people or organisations that could inappropriately influence (bias) their work.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Orthopaedic Oncology, Grosshadern Medical Center, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany

    Sandra Utzschneider, Ewa Wicherek, Patrick Weber, Volkmar Jansson & Hans Roland Dürr

  2. Department of Radiology, Grosshadern Medical Center, Ludwig-Maximilians-University of Munich, Munich, Germany

    Gerwin Schmidt

Authors
  1. Sandra Utzschneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ewa Wicherek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrick Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gerwin Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Volkmar Jansson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hans Roland Dürr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hans Roland Dürr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Utzschneider, S., Wicherek, E., Weber, P. et al. Surgical treatment of bone metastases in patients with lung cancer. International Orthopaedics (SICOT) 35, 731–736 (2011). https://doi.org/10.1007/s00264-010-1074-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-010-1074-9

Keywords

Search

Navigation