Surgery of non-spinal skeletal metastases in renal cell carcinoma

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http://hdl.handle.net/10138/161257

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Ratasvuori , M , Sillanpaa , N , Wedin , R , Trovik , C , Hansen , B H & Laitinen , M 2016 , ' Surgery of non-spinal skeletal metastases in renal cell carcinoma ' , Acta Orthopaedica , vol. 87 , no. 2 , pp. 183-188 . https://doi.org/10.3109/17453674.2015.1127726

Title: Surgery of non-spinal skeletal metastases in renal cell carcinoma
Author: Ratasvuori, Maire; Sillanpaa, Niko; Wedin, Rikard; Trovik, Clement; Hansen, Bjarne H.; Laitinen, Minna
Contributor: University of Helsinki, Clinicum
University of Helsinki, Tampere University Hospital (TAYS)
Date: 2016-03-03
Language: eng
Number of pages: 6
Belongs to series: Acta Orthopaedica
ISSN: 1745-3674
URI: http://hdl.handle.net/10138/161257
Abstract: Background and purpose - Surgery for metastases of renal cell carcinoma has increased in the last decade. It carries a risk of massive blood loss, as tumors are hypervascular and the surgery is often extensive. Preoperative embolization is believed to facilitate surgery. We evaluated the effect of preoperative embolization and resection margin on intraoperative blood loss, operation time, and survival in non-spinal skeletal metastases of renal cell carcinoma. Patients and methods - This retrospective study involved 144 patients, 56 of which were treated preoperatively with embolization. The primary outcome was intraoperative blood loss. We also identified factors affecting operating time and survival. Results - We did not find statistically significant effects on intraoperative blood loss of preoperative embolization of skeletal non-spinal metastases. Pelvic localization and large tumor size increased intraoperative blood loss. Marginal resection compared to intralesional resection, nephrectomy, level of hemoglobin, and solitary metastases were associated with better survival. Interpretation - Tumor size, but not embolization, was an independent factor for intraoperative blood loss. Marginal resection rather than intralesional resection should be the gold standard treatment for skeletal metastases in non-spinal renal cell carcinoma, especially in the case of a solitary lesion, as this improved the overall survival.
Subject: INTRAOPERATIVE BLOOD-LOSS
PREOPERATIVE EMBOLIZATION
BONE METASTASES
SURGICAL-TREATMENT
PATIENT SURVIVAL
OSSEOUS METASTASES
SINGLE-CENTER
COMPLICATIONS
OUTCOMES
TUMORS
3126 Surgery, anesthesiology, intensive care, radiology
3122 Cancers
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