Prognosis and treatment of acrometastases: Observational study of 35 cases treated in a single institution
Machado V (1), San-Julian M (2)
(1) Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, España.
(2) Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, España.
Magazine: Revista Española de Cirugía Ortopédica y Traumatología
Date: Jul 7, 2018Orthopedic Surgery and Traumatology [SP] Musculoskeletal Tumours Area
There is a degree of contradiction in the literature about the primary tumour that is most frequently associated with acrometastases, as well as their prognosis and treatment. The aim of this study is to determine the most frequent location of the acrometastases, the most frequent primary tumour according to its location, and to evaluate the surgical options according to the estimated survival.
A retrospective study on patients diagnosed with acrometastases. The primary tumour, as well as the number, location, symptoms and treatment of the acrometastases and survival rate were collected.
35 acrometastases in 21 patients were reviewed: 4 in the upper limbs and 31 in the lower limbs; the tibia was the most frequently affected bone (N=13). The primary tumour that most frequently produced acrometastases in the lower limb was hypernephroma (19%). In the upper limb lung tumour was more frequent (25%). Eleven patients died (52%); 10 of them had concomitant multiple metastases. The mean survival was 42 months from the diagnosis of acrometastases.
Acrometastases are more frequently seen in the lower extremities and the most frequent tumour was hypernephroma followed by lung. The treatment of acrometastases depends on the prognosis of the primary tumour, so a multidisciplinary approach is essential. The mean survival in our series did not imply a poorer prognosis for acrometastases, so it is feasible to consider surgical options such as wide resection and reconstruction. A unique acrometastases is a good prognosis signal.
CITATION Rev Esp Cir Ortop Traumatol. 2019 Jan - Feb;63(1):49-55. doi: 10.1016/j.recot.2018.05.001. Epub 2018 Jul 7.
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