Clinical outcomes and survival following treatment of bone metastases from uterine leiomyosarcoma: A report of 6 cases.

IF 1.1 4区医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2022-07-01 DOI:10.5152/j.aott.2022.22002

Zehra Öztürk Başarır, Mustafa Onur Karaca, Kamil Balaban, Kerem Başarır

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Abstract

Objective: This study aimed to analyze the patient-reported outcomes and survival following surgical treatment of bone metastases from (uLMS) uterine leiomyosarcoma.

Methods: A retrospective review of six patients undergoing surgical procedures for metastatic uLMS over seven years was conducted at a single center. All patients were reviewed for their primary malignancy and characteristics of bone metastasis during follow-up. Clinical presentation of bone metastasis, modality, and the type of treatment related to musculoskeletal involvement were also analyzed. The visual analog pain scale (VAS) and Eastern Cooperative Oncology Group (ECOG) performance status scale were used pre-and postoperatively to evaluate the patient-reported outcome.

Results: Four patients had solitary bone metastases, whereas multiple bone metastases were diagnosed in two. Of those who had solitary bone metastasis, all of them were treated with wide resection. One of the two patients with multiple bone metastases was also treated with wide resection, and the other was treated with intralesional curettage. Four patients died from primary disease, and two were alive without evidence of disease recurrence. The median survival time following a diagnosis of bone metastasis was 15.0 months (95% CI, 0.6 to 29.4 months). The mean VAS scores for all six patients improved. However, the improvement in ECOG performance status was seen in only four patients.

Conclusion: Although the prognosis of uLMS patients with bone metastasis seems poor, wide resection of the solitary bone metastasis may help prolong the overall survival. Performing orthopedic surgeries for the bone metastasis from uLMS in case of intractable pain after palliative radiotherapy, impending or pathological fracture, or solitary disease has been shown to decrease the pain significantly and improve the performance status in the majority.

Level of evidence: Level IV, Therapeutic Study.

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子宫平滑肌肉瘤骨转移治疗6例临床疗效及生存率分析

目的:本研究旨在分析子宫平滑肌肉瘤骨转移手术治疗后患者报告的预后和生存率。方法:在一个中心对6例7年来接受转移性uLMS手术的患者进行回顾性分析。在随访期间对所有患者的原发恶性肿瘤和骨转移特征进行了回顾。骨转移的临床表现、方式和与肌肉骨骼受累相关的治疗类型也进行了分析。术前和术后采用视觉模拟疼痛量表(VAS)和东部肿瘤合作组(ECOG)表现状态量表评估患者报告的结果。结果:4例为单发骨转移，2例为多发骨转移。单发骨转移者均行大范围切除。2例多发骨转移患者中1例也行广泛切除，另1例行病灶内刮除。4例患者死于原发疾病，2例存活，无疾病复发迹象。诊断为骨转移后的中位生存时间为15.0个月(95% CI, 0.6至29.4个月)。所有6名患者的平均VAS评分均有所改善。然而，只有4例患者的ECOG表现有所改善。结论:虽然uLMS合并骨转移患者预后较差，但广泛切除单发骨转移灶可能有助于延长总生存期。对于姑息性放疗后出现难治性疼痛、即将发生或病理性骨折或孤立性疾病的uLMS骨转移患者，进行骨科手术治疗可显著减轻疼痛，并改善大多数患者的运动状态。证据等级:IV级，治疗性研究。

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来源期刊

Acta orthopaedica et traumatologica turcica ORTHOPEDICS-

CiteScore

2.00

自引率

0.00%

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审稿时长

>12 weeks

期刊介绍： Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.