Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2014

Open Access 01-12-2014 | Research

Can surgical management of bone metastases improve quality of life among women with gynecologic cancer?

Authors: Tao Ji, Ramez Eskander, Yifei Wang, Kunkun Sun, Bang H Hoang, Wei Guo

Published in: World Journal of Surgical Oncology | Issue 1/2014

Login to get access

Abstract

Background

The evaluation, counseling, and management of gynecologic patients with bone metastasis remain a challenge for clinicians. In order to critically evaluate the role of surgery, we retrospectively analyzed the records of 18 patients surgically treated for metastatic gynecologic tumors of bone, focusing on quality of life, local tumor control, and survival.

Methods

Eighteen patients underwent surgical procedures for the treatment of bone metastases secondary to gynecologic cancer between September 2003 and April 2012. The primary cancer sites included the uterus (n = 10), the cervix (n = 5), and an ovary (n = 3). Patients were followed for an average period of 13.8 months (range, 2 to 34 months). A visual analog pain scale (VAS) and Eastern Cooperative Oncology Group (ECOG) performance status were evaluated both pre- and postoperatively.

Results

The median survival time following diagnosis of bone metastasis was 10.0 months. The mean VAS score was 5.8 preoperatively compared with 2.1, 3 months after surgery. The mean pre and postoperative ECOG performance status grades were 3.1 and 2.3, respectively.

Conclusions

The prognosis of gynecological cancer patients with bone metastasis is poor. Some patients had improvement in their quality of life after surgical intervention for bone metastases; however, novel integrated treatment modalities should be investigated.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference Fulcher AS, O’Sullivan SG, Segreti EM, Kavanagh BD: Recurrent cervical carcinoma: typical and atypical manifestations. Radiographics. 1999, 19: S103-S116. quiz S264-105CrossRefPubMed Fulcher AS, O’Sullivan SG, Segreti EM, Kavanagh BD: Recurrent cervical carcinoma: typical and atypical manifestations. Radiographics. 1999, 19: S103-S116. quiz S264-105CrossRefPubMed
3.
go back to reference Abdul-Karim FW, Kida M, Wentz WB, Carter JR, Sorensen K, Macfee M, Zika J, Makley JT: Bone metastasis from gynecologic carcinomas: a clinicopathologic study. Gynecol Oncol. 1990, 39: 108-114.CrossRefPubMed Abdul-Karim FW, Kida M, Wentz WB, Carter JR, Sorensen K, Macfee M, Zika J, Makley JT: Bone metastasis from gynecologic carcinomas: a clinicopathologic study. Gynecol Oncol. 1990, 39: 108-114.CrossRefPubMed
4.
go back to reference Rose PG, Piver MS, Tsukada Y, Lau T: Patterns of metastasis in uterine sarcoma. An Autopsy Study. Cancer. 1989, 63: 935-938.CrossRefPubMed Rose PG, Piver MS, Tsukada Y, Lau T: Patterns of metastasis in uterine sarcoma. An Autopsy Study. Cancer. 1989, 63: 935-938.CrossRefPubMed
5.
go back to reference Cormio G, Rossi C, Cazzolla A, Resta L, Loverro G, Greco P, Selvaggi L: Distant metastases in ovarian carcinoma. Int J Gynecol Cancer. 2003, 13: 125-129.CrossRefPubMed Cormio G, Rossi C, Cazzolla A, Resta L, Loverro G, Greco P, Selvaggi L: Distant metastases in ovarian carcinoma. Int J Gynecol Cancer. 2003, 13: 125-129.CrossRefPubMed
6.
go back to reference Thanapprapasr D, Nartthanarung A, Likittanasombut P, Na Ayudhya NI, Charakorn C, Udomsubpayakul U, Subhadarbandhu T, Wilailak S: Bone metastasis in cervical cancer patients over a 10-year period. Int J Gynecol Cancer. 2010, 20: 373-378.CrossRefPubMed Thanapprapasr D, Nartthanarung A, Likittanasombut P, Na Ayudhya NI, Charakorn C, Udomsubpayakul U, Subhadarbandhu T, Wilailak S: Bone metastasis in cervical cancer patients over a 10-year period. Int J Gynecol Cancer. 2010, 20: 373-378.CrossRefPubMed
7.
go back to reference Matsuyama T, Tsukamoto N, Imachi M, Nakano H: Bone metastasis from cervix cancer. Gynecol Oncol. 1989, 32: 72-75.CrossRefPubMed Matsuyama T, Tsukamoto N, Imachi M, Nakano H: Bone metastasis from cervix cancer. Gynecol Oncol. 1989, 32: 72-75.CrossRefPubMed
8.
go back to reference Falicov A, Fisher CG, Sparkes J, Boyd MC, Wing PC, Dvorak MF: Impact of surgical intervention on quality of life in patients with spinal metastases. Spine (Phila Pa 1976). 2006, 31: 2849-2856.CrossRef Falicov A, Fisher CG, Sparkes J, Boyd MC, Wing PC, Dvorak MF: Impact of surgical intervention on quality of life in patients with spinal metastases. Spine (Phila Pa 1976). 2006, 31: 2849-2856.CrossRef
9.
go back to reference Hoshi M, Takada J, Ieguchi M, Takahashi S, Nakamura H: Prognostic factors for patients with solitary bone metastasis. Int J Clin Oncol. 2013, 18: 164-169.CrossRefPubMed Hoshi M, Takada J, Ieguchi M, Takahashi S, Nakamura H: Prognostic factors for patients with solitary bone metastasis. Int J Clin Oncol. 2013, 18: 164-169.CrossRefPubMed
10.
go back to reference Nathan SS, Healey JH, Mellano D, Hoang B, Lewis I, Morris CD, Athanasian EA, Boland PJ: Survival in patients operated on for pathologic fracture: implications for end-of-life orthopedic care. J Clin Oncol. 2005, 23: 6072-6082.CrossRefPubMed Nathan SS, Healey JH, Mellano D, Hoang B, Lewis I, Morris CD, Athanasian EA, Boland PJ: Survival in patients operated on for pathologic fracture: implications for end-of-life orthopedic care. J Clin Oncol. 2005, 23: 6072-6082.CrossRefPubMed
11.
go back to reference Tjalma WA, Somville J: Fibula metastasis as the presenting feature of vaginal cancer. Eur J Gynaecol Oncol. 2011, 32: 114-116.PubMed Tjalma WA, Somville J: Fibula metastasis as the presenting feature of vaginal cancer. Eur J Gynaecol Oncol. 2011, 32: 114-116.PubMed
12.
go back to reference Jiang GQ, Gao YN, Gao M, Zheng H, Yan X, Wang W, An N, Cao K: Clinicopathological features and treatment of extremity bone metastasis in patients with endometrial carcinoma: a case report and review. Chin Med J (Engl). 2011, 124: 622-626. Jiang GQ, Gao YN, Gao M, Zheng H, Yan X, Wang W, An N, Cao K: Clinicopathological features and treatment of extremity bone metastasis in patients with endometrial carcinoma: a case report and review. Chin Med J (Engl). 2011, 124: 622-626.
13.
go back to reference Corrado G, Santaguida S, Zannoni G, Scambia G, Ferrandina G: Femur metastasis in carcinoma of the uterine cervix: a rare entity. Arch Gynecol Obstet. 2010, 281: 963-965.PubMedCentralCrossRefPubMed Corrado G, Santaguida S, Zannoni G, Scambia G, Ferrandina G: Femur metastasis in carcinoma of the uterine cervix: a rare entity. Arch Gynecol Obstet. 2010, 281: 963-965.PubMedCentralCrossRefPubMed
14.
go back to reference Chen YL, Hsiao SM, Lin MC, Lin HH: Bone metastasis as the initial presentation in one case of ovarian cancer with two components of endometrioid adenocarcinoma and adenosarcoma. Taiwan J Obstet Gynecol. 2009, 48: 298-301.CrossRefPubMed Chen YL, Hsiao SM, Lin MC, Lin HH: Bone metastasis as the initial presentation in one case of ovarian cancer with two components of endometrioid adenocarcinoma and adenosarcoma. Taiwan J Obstet Gynecol. 2009, 48: 298-301.CrossRefPubMed
15.
go back to reference Du ZY, Zang J, Tang XD, Guo W: Experts’ agreement on therapy for bone metastases. Orthop Surg. 2010, 2: 241-253.CrossRefPubMed Du ZY, Zang J, Tang XD, Guo W: Experts’ agreement on therapy for bone metastases. Orthop Surg. 2010, 2: 241-253.CrossRefPubMed
16.
go back to reference Blecharz P, Urbanski K, Mucha-Malecka A, Malecki K, Reinfuss M, Jakubowicz J, Skotnicki P: Hematogenous metastases in patients with Stage I or II endometrial carcinoma. Strahlenther Onkol. 2011, 187: 806-811.CrossRefPubMed Blecharz P, Urbanski K, Mucha-Malecka A, Malecki K, Reinfuss M, Jakubowicz J, Skotnicki P: Hematogenous metastases in patients with Stage I or II endometrial carcinoma. Strahlenther Onkol. 2011, 187: 806-811.CrossRefPubMed
17.
go back to reference Chang KH, Lee JP, Ryu HS: Rare case of stage IA epithelial ovarian cancer with bone as the first site of recurrent metastasis. Int J Gynecol Cancer. 2006, 16 (Suppl 1): 322-326.CrossRefPubMed Chang KH, Lee JP, Ryu HS: Rare case of stage IA epithelial ovarian cancer with bone as the first site of recurrent metastasis. Int J Gynecol Cancer. 2006, 16 (Suppl 1): 322-326.CrossRefPubMed
18.
go back to reference Vizzielli G, Fanfani F, Costantini B, Gallotta V, Scambia G, Fagotti A: External hemipelvectomy as treatment for solitary coxofemoral metastasis from endometrial carcinoma: case report and review of the literature. J Obstet Gynaecol Res. 2012, 38: 892-898.CrossRefPubMed Vizzielli G, Fanfani F, Costantini B, Gallotta V, Scambia G, Fagotti A: External hemipelvectomy as treatment for solitary coxofemoral metastasis from endometrial carcinoma: case report and review of the literature. J Obstet Gynaecol Res. 2012, 38: 892-898.CrossRefPubMed
19.
go back to reference Ratanatharathorn V, Powers WE, Steverson N, Han I, Ahmad K, Grimm J: Bone metastasis from cervical cancer. Cancer. 1994, 73: 2372-2379.CrossRefPubMed Ratanatharathorn V, Powers WE, Steverson N, Han I, Ahmad K, Grimm J: Bone metastasis from cervical cancer. Cancer. 1994, 73: 2372-2379.CrossRefPubMed
20.
go back to reference Ishibashi M, Fujiwaki R, Nakayama I, Miura H, Sawada K: Endometrial carcinosarcoma presenting as a tibial metastasis. Int J Clin Oncol. 2007, 12: 305-308.CrossRefPubMed Ishibashi M, Fujiwaki R, Nakayama I, Miura H, Sawada K: Endometrial carcinosarcoma presenting as a tibial metastasis. Int J Clin Oncol. 2007, 12: 305-308.CrossRefPubMed
21.
go back to reference Sahinler I, Erkal H, Akyazici E, Atkovar G, Okkan S: Endometrial carcinoma and an unusual presentation of bone metastasis: a case report. Gynecol Oncol. 2001, 82: 216-218.CrossRefPubMed Sahinler I, Erkal H, Akyazici E, Atkovar G, Okkan S: Endometrial carcinoma and an unusual presentation of bone metastasis: a case report. Gynecol Oncol. 2001, 82: 216-218.CrossRefPubMed
22.
go back to reference Loizzi V, Cormio G, Cuccovillo A, Fattizzi N, Selvaggi L: Two cases of endometrial cancer diagnosis associated with bone metastasis. Gynecol Obstet Invest. 2006, 61: 49-52.CrossRefPubMed Loizzi V, Cormio G, Cuccovillo A, Fattizzi N, Selvaggi L: Two cases of endometrial cancer diagnosis associated with bone metastasis. Gynecol Obstet Invest. 2006, 61: 49-52.CrossRefPubMed
23.
go back to reference Kumar R, Gupta R, Khullar S, Padhy AK, Julka PK, Malhotra A: Bone scanning for bone metastasis in carcinoma cervix. J Assoc Physicians India. 2000, 48: 808-810.PubMed Kumar R, Gupta R, Khullar S, Padhy AK, Julka PK, Malhotra A: Bone scanning for bone metastasis in carcinoma cervix. J Assoc Physicians India. 2000, 48: 808-810.PubMed
24.
go back to reference Sugiura H, Yamada K, Sugiura T, Hida T, Mitsudomi T: Predictors of survival in patients with bone metastasis of lung cancer. Clin Orthop Relat Res. 2008, 466: 729-736.PubMedCentralCrossRefPubMed Sugiura H, Yamada K, Sugiura T, Hida T, Mitsudomi T: Predictors of survival in patients with bone metastasis of lung cancer. Clin Orthop Relat Res. 2008, 466: 729-736.PubMedCentralCrossRefPubMed
25.
go back to reference Lin CC, Chen PQ, Chen WJ, Chen LH: Prognosis of operative treatment for metastatic hepatocellular carcinoma of the spine. Clin Orthop Relat Res. 2006, 444: 209-215.CrossRefPubMed Lin CC, Chen PQ, Chen WJ, Chen LH: Prognosis of operative treatment for metastatic hepatocellular carcinoma of the spine. Clin Orthop Relat Res. 2006, 444: 209-215.CrossRefPubMed
26.
go back to reference Forsberg JA, Eberhardt J, Boland PJ, Wedin R, Healey JH: Estimating survival in patients with operable skeletal metastases: an application of a bayesian belief network. PLoS One. 2011, 6: e19956-PubMedCentralCrossRefPubMed Forsberg JA, Eberhardt J, Boland PJ, Wedin R, Healey JH: Estimating survival in patients with operable skeletal metastases: an application of a bayesian belief network. PLoS One. 2011, 6: e19956-PubMedCentralCrossRefPubMed
27.
go back to reference Khan FA, Rose PS, Yanagisawa M, Lewallen DG, Sim FH: Surgical technique: Porous tantalum reconstruction for destructive nonprimary periacetabular tumors. Clin Orthop Relat Res. 2012, 470: 594-601.PubMedCentralCrossRefPubMed Khan FA, Rose PS, Yanagisawa M, Lewallen DG, Sim FH: Surgical technique: Porous tantalum reconstruction for destructive nonprimary periacetabular tumors. Clin Orthop Relat Res. 2012, 470: 594-601.PubMedCentralCrossRefPubMed
28.
go back to reference Ji T, Guo W, Yang RL, Tang S, Sun X: Clinical outcome and quality of life after surgery for peri-acetabular metastases. J Bone Joint Surg (Br). 2011, 93: 1104-1110.CrossRef Ji T, Guo W, Yang RL, Tang S, Sun X: Clinical outcome and quality of life after surgery for peri-acetabular metastases. J Bone Joint Surg (Br). 2011, 93: 1104-1110.CrossRef
29.
go back to reference Coleman RE: Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006, 12: 6243s-6249s.CrossRefPubMed Coleman RE: Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006, 12: 6243s-6249s.CrossRefPubMed
31.
go back to reference Harvey N, Ahlmann ER, Allison DC, Wang L, Menendez LR: Endoprostheses last longer than intramedullary devices in proximal femur metastases. Clin Orthop Relat Res. 2012, 470: 684-691.PubMedCentralCrossRefPubMed Harvey N, Ahlmann ER, Allison DC, Wang L, Menendez LR: Endoprostheses last longer than intramedullary devices in proximal femur metastases. Clin Orthop Relat Res. 2012, 470: 684-691.PubMedCentralCrossRefPubMed
32.
go back to reference Yazawa Y, Frassica FJ, Chao EY, Pritchard DJ, Sim FH, Shives TC: Metastatic bone disease. A study of the surgical treatment of 166 pathologic humeral and femoral fractures. Clin Orthop Relat Res. 1990, 251: 213-219.PubMed Yazawa Y, Frassica FJ, Chao EY, Pritchard DJ, Sim FH, Shives TC: Metastatic bone disease. A study of the surgical treatment of 166 pathologic humeral and femoral fractures. Clin Orthop Relat Res. 1990, 251: 213-219.PubMed
33.
go back to reference Gainor BJ, Buchert P: Fracture healing in metastatic bone disease. Clin Orthop Relat Res. 1983, 178: 297-302.PubMed Gainor BJ, Buchert P: Fracture healing in metastatic bone disease. Clin Orthop Relat Res. 1983, 178: 297-302.PubMed
Metadata
Title
Can surgical management of bone metastases improve quality of life among women with gynecologic cancer?
Authors
Tao Ji
Ramez Eskander
Yifei Wang
Kunkun Sun
Bang H Hoang
Wei Guo
Publication date
01-12-2014
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2014
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-12-250

Other articles of this Issue 1/2014

World Journal of Surgical Oncology 1/2014 Go to the issue