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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 11/2017

01-11-2017 | Orthopaedic Surgery

Skeletal muscle metastasis from the most common carcinomas orthopedic surgeons deal with. A systematic review of the literature

Authors: Juan Pretell-Mazzini, Jaime Zorrilla S. de Neyra, Gonzalo Luengo-Alonso, Shai Shemesh

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2017

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Abstract

Introduction

There is scarce information in the literature dealing with the clinical presentation, management and oncologic outcomes of skeletal muscle metastases (SMM). We sought to perform a systematic review of the literature to investigate: (1) tumor characteristics of SMM, (2) therapeutic approach, and (3) oncological outcomes.

Methods

A systematic review of the literature was performed using PubMed and EMBASE search engines. A total of 3231 references were reviewed and 49 studies were included. Demographic data, presentation characteristics, and oncological outcomes were recorded. Statistical analysis was performed using SPSS 22.0 software (IBM; Armonk, New York) and Comprehensive Meta-Analysis software version 3 (Biostat, Inc.), with p < 0.05 as statistically significant.

Results

A total of 231 patients were included. These tumors presented more commonly on males 58.4% (135/231), with a mean age of 60.08 ± 10.6 years, and in the axial area 39.6% (88/222). The most common carcinoma type was lung 41.1% (95/231). Resection of a single metastases did not change survival significantly (p = 0.992). LRR was higher within the group of patients that underwent WLE compared with non-WLE [31.3% (23/74) vs. 8.7% (2/23), p ≤ 0.001]. Kaplan–Meier survival analysis for the entire cohort showed an estimate of 15.3 months [95% confidence interval (CI) 11.6–19; standard error (SE) 0.432], with lung carcinoma carrying the worst prognosis 6.7 months (95% CI 5.4–8.07; SE 0.68). Patients with a single SMM showed a worse estimate mean survival time compared to patients with multiple metastases limited to muscles [8.6 months (95% CI 4.7–12.5; SE 2.0) vs 25.4 months (95% CI 19.8–31.05; SE 2.8; p ≤ 0.001)].

Conclusions

Overall survival is poor and is driven mainly by the type of carcinoma. An Increased LRR might be present due to the systemic nature of the condition, and degree of control of the primary carcinoma.
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Metadata
Title
Skeletal muscle metastasis from the most common carcinomas orthopedic surgeons deal with. A systematic review of the literature
Authors
Juan Pretell-Mazzini
Jaime Zorrilla S. de Neyra
Gonzalo Luengo-Alonso
Shai Shemesh
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 11/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-017-2782-z

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