AIM: To evaluate epidemiology, prognosis and diagnostics in metastatic @entity79 and identify risk factors for failure after operation for pathologic @entity174 . @entity1 : The study was based on @entity1 treated for skeletal metastases, @entity1582 or @entity706 between 1986 and 1998 at the Oncology Service, Department of Orthopedics, Karolinska Hospital and on @entity1 diagnosed with symptomatic skeletal metastases 1989-1994 in the Stockholm Region. EPIDEMIOLOGY: 641 @entity0 @entity1 were diagnosed with symptomatic skeletal metastases 1989-1994. Based upon 1100 new primary @entity0 cases yearly, the overall risk of developing symptomatic skeletal metastases was 10-15%. One out of 5 @entity1 with skeletal metastases required surgical treatment for skeletal complications. PROGNOSIS: The survival rate after surgical treatment for skeletal complications was 0.3 at 1 year and 0.008 at 3 years. Multivariate analysis based on 619 @entity1 showed that complete pathologic @entity174 and soft tissue metastases were negative prognostic variables for 1-year survival after operation. Solitary skeletal metastasis, breast, prostate, @entity703 , @entity1582 , and @entity706 were positive variables. DIAGNOSIS: @entity400 ( @entity400 ) was assessed in 110 @entity1 for diagnostic accuracy and to which extent information about primary site of the @entity189 could be gained. There were 80 @entity1 with @entity189 , 14 with @entity706 , and 16 with @entity1582 . @entity400 offered correct diagnosis in 9 of 10 @entity1 and also provided guidance in the search for the primary lesions. Hence, 27 of 30 @entity1582 or @entity706 were diagnosed by @entity400 and in half of the @entity1 with @entity189 the site of the @entity5 could be ascertained. For @entity1 with a suspected skeletal metastasis the search for the @entity5 may preferably start with @entity400 . SURGICAL TREATMENT: Risk factors for failure after operation for pathologic @entity174 were identified in 192 @entity1 treated for 228 metastatic lesions of the long bones. 26 out of 228 procedures (11%) lead to failures necessitating reoperation. Long survival after surgery was the most important risk factor for failure of the reconstruction. @entity703 was the @entity5 associated with the highest rate of reoperations. Reoperations were more common in the femur than in the humerus. Reconstructions based on prosthetic as opposed to osteosynthetic devices appeared safer. There was a tendency for a high reoperation rate in hospitals with few treated @entity1 . CONCLUSION: To decrease the risk of reoperation, it is important to identify @entity1 with a long expected survival. @entity1 with a good prognosis should be considered for wide resection and reconstruction as applied in primary @entity3478 .

Surgical treatment for pathologic XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity706 :: ('MESH:D008223', 'Disease') :: ['lymphoma', 'lymphomas'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture'] @entity5 :: ('MESH:D009369', 'Disease') :: ['primary tumor'] @entity3478 :: ('MESH:D001859', 'Disease') :: ['malignant bone tumors'] @entity189 :: ('MESH:D002277', 'Disease') :: ['metastatic carcinoma'] @entity1582 :: ('MESH:D009101', 'Disease') :: ['myeloma'] @entity79 :: ('MESH:D001847', 'Disease') :: ['bone disease'] @entity400 :: ('MESH:D014202', 'Disease') :: ['Fine Needle Aspiration Biopsy', 'FNAB'] @entity703 :: ('MESH:D007680', 'Disease') :: ['kidney cancer', 'Kidney cancer']
@entity174 :: (MESH:D050723,Disease) :: ['fracture']
