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Metastasectomy, intralesional resection, or stabilization only in the treatment of bone metastases from renal cell carcinoma.

Abstract The mainstay of treatment for bone metastases from renal cell carcinoma is surgery. We assessed if there was a difference in local recurrence, reoperation, and survival between patients who underwent metastasectomy, intralesional curettage, or stabilization only for renal cell carcinoma metastasis to the appendicular skeleton, and if there was a difference in these outcomes based on margin status.
PMID
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Authors

Mayor MeshTerms
Keywords

bone metastasis

intralesional curettage

metastasectomy

renal cell carcinoma

resection

Journal Title journal of surgical oncology
Publication Year Start




PMID- 27156495
OWN - NLM
STAT- MEDLINE
DCOM- 20170221
LR  - 20170221
IS  - 1096-9098 (Electronic)
IS  - 0022-4790 (Linking)
VI  - 114
IP  - 2
DP  - 2016 Aug
TI  - Metastasectomy, intralesional resection, or stabilization only in the treatment
      of bone metastases from renal cell carcinoma.
PG  - 237-45
LID - 10.1002/jso.24284 [doi]
AB  - BACKGROUND: The mainstay of treatment for bone metastases from renal cell
      carcinoma is surgery. We assessed if there was a difference in local recurrence, 
      reoperation, and survival between patients who underwent metastasectomy,
      intralesional curettage, or stabilization only for renal cell carcinoma
      metastasis to the appendicular skeleton, and if there was a difference in these
      outcomes based on margin status. METHODS: This retrospective study included 183
      patients; 48% underwent metastasectomy (n = 88, margins: 64 negative; 20
      positive; 4 unclear), 30% intralesional curettage (n = 54), and 22% stabilization
      only (n = 41). RESULTS: The recurrence rate differed and was highest after
      stabilization only (39%), followed by intralesional curettage (22%), and
      metastasectomy (12%) (P = 0.003). However, we found no difference in reoperation 
      rate (P = 0.847). Survival was better in patients who underwent metastasectomy (P
      = 0.020). The recurrence rate was lower in patients who had a negative margin
      (5%) as compared to those with a positive margin (26%) (P < 0.001). However, we
      found no difference in reoperation rate (P = 0.97). Negative margins showed
      better survival (P < 0.001). CONCLUSIONS: Our findings emphasize the importance
      of obtaining negative margins in patients with a good life expectancy, as lower
      recurrence rate can be attained at a not significant additional risk for
      reoperation, with a potential impact on survival. J. Surg. Oncol.
      2016;114:237-245. (c) 2016 Wiley Periodicals, Inc.
CI  - (c) 2016 Wiley Periodicals, Inc.
FAU - Langerhuizen, David W G
AU  - Langerhuizen DW
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts
      General Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Janssen, Stein J
AU  - Janssen SJ
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts
      General Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - van der Vliet, Quirine M J
AU  - van der Vliet QM
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts
      General Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Raskin, Kevin A
AU  - Raskin KA
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts
      General Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Ferrone, Marco L
AU  - Ferrone ML
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Brigham and
      Women's Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Hornicek, Francis J
AU  - Hornicek FJ
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts
      General Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Schwab, Joseph H
AU  - Schwab JH
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts
      General Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Lozano-Calderon, Santiago A
AU  - Lozano-Calderon SA
AD  - Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts
      General Hospital, Harvard Medical School, Boston, Massachusetts.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20160509
PL  - United States
TA  - J Surg Oncol
JT  - Journal of surgical oncology
JID - 0222643
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bone Neoplasms/mortality/*secondary/surgery
MH  - Carcinoma, Renal Cell/*pathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Kidney Neoplasms/*pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - Reoperation
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - bone metastasis
OT  - intralesional curettage
OT  - metastasectomy
OT  - renal cell carcinoma
OT  - resection
EDAT- 2016/05/10 06:00
MHDA- 2017/02/22 06:00
CRDT- 2016/05/10 06:00
PHST- 2016/03/14 00:00 [received]
PHST- 2016/04/23 00:00 [accepted]
PHST- 2016/05/10 06:00 [entrez]
PHST- 2016/05/10 06:00 [pubmed]
PHST- 2017/02/22 06:00 [medline]
AID - 10.1002/jso.24284 [doi]
PST - ppublish
SO  - J Surg Oncol. 2016 Aug;114(2):237-45. doi: 10.1002/jso.24284. Epub 2016 May 9.