Functional Outcome and Survival rate of Metastatic Bone Disease on femur And Pelvic Bone after Surgical Treatment

Introduction. Most groups of cancers that often metastasize to bone invariably induce pathological fractures. Between 9-29% of patients with metastases will have a pathological fracture and 90% of fractures require surgery. Fractures on pathologic bone have a major impact on life quality.Methods. Between 2013 - 2017, 30 patients with metastatic tumors on the femur and pelvic were treated at Cipto Mangunkusomo Hospital. Basic patients’ medical records were analyzed, with particular focus on the cancer type, age, gender, tumor site, mechanism of fracture, treatment type, survival rate (Kaplan Meier test), and functional outcome (MSTS score).Results. Eleven patients were male and nineteen patients were female. The mean age was 56 + 7 years. The MSTS score was excellent in 10 (33.3%), moderate in 4 (13.3%), and poor in 4 (13.3%). The tumor located in the shaft femur and treated by ORIF had the highest mean MSTS score. Slipped was the most common mechanism of injury due to pathological fracture The mean survival time of metastatic bone from the four most common tumor origin were 6 months (lung), 4.33 months (multiple myeloma) 18.75 months (thyroid), and 20.33 months (breast). The data were then analyzed using the Kaplan-Meier method and Log Rank (Mantel-Cox) test. From this data, the equality of survival distribution using the Log Rank (Mantel-Cox) test was calculated, and found that the P value was 0.003. It means that there is a significant difference between survival rate and tumor origin.Conclusions. Pathologic fractures in patients with metastatic cancer needed a combination of surgical and oncological treatment. Patients were treated surgically, and most of them have an excellent functional outcome. The survival rate varied, based on cancer type.