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

Juan Abelardo Augusto Pretell, Jaime Zorrilla S. de Neyra, Gonzalo Luengo-Alonso, Shai Shemesh

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1477-1489
Number of pages13
JournalArchives of Orthopaedic and Trauma Surgery
Volume137
Issue number11
DOIs
StatePublished - Nov 1 2017

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Skeletal Muscle
Neoplasm Metastasis
Carcinoma
Confidence Intervals
Software
Search Engine
Lung
Survival
Survival Analysis
PubMed
Meta-Analysis
Neoplasms
Survival Rate
Demography
Orthopedic Surgeons
Muscles
Therapeutics

Keywords

  • Breast carcinoma
  • Local recurrence
  • Lung carcinoma
  • Poor outcome
  • Skeletal muscle metastasis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Skeletal muscle metastasis from the most common carcinomas orthopedic surgeons deal with. A systematic review of the literature. / Pretell, Juan Abelardo Augusto; de Neyra, Jaime Zorrilla S.; Luengo-Alonso, Gonzalo; Shemesh, Shai.

In: Archives of Orthopaedic and Trauma Surgery, Vol. 137, No. 11, 01.11.2017, p. 1477-1489.

Research output: Contribution to journalArticle

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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.",
keywords = "Breast carcinoma, Local recurrence, Lung carcinoma, Poor outcome, Skeletal muscle metastasis",
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T1 - Skeletal muscle metastasis from the most common carcinomas orthopedic surgeons deal with. A systematic review of the literature

AU - Pretell, Juan Abelardo Augusto

AU - de Neyra, Jaime Zorrilla S.

AU - Luengo-Alonso, Gonzalo

AU - Shemesh, Shai

PY - 2017/11/1

Y1 - 2017/11/1

N2 - 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.

AB - 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.

KW - Breast carcinoma

KW - Local recurrence

KW - Lung carcinoma

KW - Poor outcome

KW - Skeletal muscle metastasis

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