Nevzat DABAK, Hasan GOCER, Alper CİRAKLİ

The analysis of operative metastatic tumors in the skeleton

Amaç: Kliniğimizde iskelet sistemi tutulumlu metastatik kemik tümörü nedeniyle takip ve cerrahi tedavi edilen olguların incelenmesi amaçlandı. Gereç ve Yöntemler: Ocak 1987-Ocak 2012 yılları arasında iskelet sistemi tutulumlu metastatik kemik tümörü nedeniyle takip ve cerrahi tedavi edilen 209 olgu retrospektif olarak incelendi. Cerrahi uygulanmayan olgular çalışmaya dahil edilmedi. Olgular yaş, cinsiyet, lokalizasyon ve primer odak açısından değerlendirildi. Elde Edilen veriler SPSS 15.0 sistemine aktarılarak analiz edildi. Bulgular: 209 olgunun 122'si (%58.4) erkek, 87'si (%41.6) kadın ve yaş ortalaması 59.2 idi. Tümörlerin 61'i (%29.2) femur proksimalinde, 44'ü (%21.1) femur cisminde, 39'u (%18.7) pelviste, 31'i (%14.8) de humerusta yerleşmiş idi. Metastatik tümörlerin 70'inin (%33.5) akciğer, 36'sının (%17.2) meme kaynaklı olduğu saptanırken, 58'inde (%27.8) ise primerinin net belirlenemediği gözlendi. Sonuç: Metastatik tümörler en sık omurgada daha sonra pelviste, üst ve alt ekstremite kemikleri proksimalinde ve kaburgalarda görülür. Yine de bu tip çalışmaların kemik ve yumuşak doku tümörleri cerrahisi yapılan merkezlerden toplanarak daha geniş serilerin oluşturulmasının halk sağlığı açısından önemli bilgiler sağlayacağını düşünüyoruz

İskelet sistemi tutulumu nedeniyle cerrahi tedavi edilen metastatik tümörlerin analizi

Objective: The purpose of the study was to examine the cases followed and surgically treated due to metastatic bone tumor with skeletal system involvement. Materials and Methods: 209 cases who were followed and surgically treated due to metastatic bone tumor with skeletal system involvement between January 1987 and January 2012 were examined retrospectively. The cases which did not receive surgery were not included. The cases were evaluated in terms of age, gender, localization and primary focus. The data obtained were analyzed through SPSS 15.0. Results: Of the 209 cases, 122 (58.4%) were men, while 87 (41.6%) were women and the average of ages was 59.2. 61 (29.2%) of the tumors were located in proximal femur, 44 (21.1%) in femur shaft, 39 (18.7%) in pelvis and 31 (14.8%) in humerus. Of the metastatic tumors, 70 (33.5%) were found to originate from lungs while 36 (17.2%) were found to originate from breasts and primary was not observed clearly in 58 (27.7%). Conclusion: Metastatic tumors are most common in spine, then pelvis, upper and lower extremity bones proximal and ribsWe are of the opinion that gathering such studies from centers which perform bone and soft tissue tumor surgery and forming wider series will provide significant information in terms of public health

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Capanna R, Campanacci DA. The treatment of metastases in the appendicular skeleton. J Bone Joint Surg Br 2001;83(4):471-81.
Hage WD, Aboulafia AJ, Aboulafia DM. Incidence, location, and diagnostic evaluation of metastatic bone disease. Orthop Clin North Am 2000;31(4):515-28.
Sim FH. Metastatic bone disease of the pelvis and femur. Instr Course Lect 1992;41:317-27.
Swanson KC, Pritchard DJ, Sim FH. Surgical treatment of metastatic disease of the femur. J Am Acad Orthop Surg 2000;8(1):56-65.
Ward WG, Spang J, Howe D. Metastatic disease of the femur. Surgical management. Orthop Clin North Am 2000;31(4):633-45.
Mayadağlı A, Bulut G, Ekici K. Metastatik Kemik Tümörlerine Yaklaşım. J Kartal TR 2011;22(1):49-55.
Brown JE, Webbe H N, Coleman RE. The role of bisphosphonates in breast and prostate cancers. Endocrine-Related Cancer 2004;11(2):207-24.
Durr HR, Muller PE, Lenz T, Baur A, Jansson V, Refior HJ. Surgical treatment of bone metastases in patients with breast cancer. Clin Orthop Relat Res 2002;396:191- 6.
Brage ME, Simon MA. Evaluation, prognosis, and medical treatment considerations of metastatic bone tumors. Orthopedics 1992;15(5):589-96.
Roodman GD. Mechanisms of bone metastasis. N Engl J Med 2004;350:1655-64.
Mirra JM, editor. Lower Extremity Metastasis. Bone Tumors. London: Lea & Febiger; 1989. p. 1496-1516.
Rosenthal DI. Radiologic diagnosis of bone metastases. Cancer 1997;15;80(8 suppl):1595-607.
Silverberg E. Cancer statistics 1986. CA Cancer J Clin 1986;36(1):9-25.
Libson E, Bloom RA, Husband JE, Stoker DJ. Metastatic tumors of bones of the hand and foot. Skeletal Radiol 1987;16(5):387-92.
Harrington KD, Sim FH, Enis JE, Johnston JO, Dick HM, Gristina AG. Methylmethacrylate as an adjunct in internal fixation of pathological fractures. Experience with three hundred and seventy-five cases. J Bone Joint Surg Am 1976;58(8):1047-55.
Harrington KD. New trends in the management of lower extremity metastases. Clin Orthop Relat Res 1982;169:53-61.
Mirels H. Metastatic disease in long bones: A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res 1989;(249):256-64.
Algan SM, Horowitz SM. Surgical treatment of pathologic hip lesions in patients with metastatic disease. Clin Orthop Relat Res 1996;(332):223-31.