PALLIATIVE SURGICAL-TREATMENT OF BONE MET ASTASES - IMPROVEMENT IN QUALITY-OF-LIFE BY EARLY INTERVENTION

Objective: To find out to what extent early operative treatment of ost eolysis or pathological fractures, resulting from improved interdiscip linary treatment of malignant tumours, affects quality of life. Patien ts and method: Using a standardised scheme of self-evaluation in a ret rospective study, quality of life was assessed in 67 patients (18 men, 49 women; mean age 64.5 +/- 11.6 years) who were operated for osteoly ses or pathological limb fractures due to malignant tumour metastases. Results: Interlocking osteosynthesis was performed in 37 patients, en doprosthetic joint replacement in 30. Duration of operation and hospit al stay were significantly shorter in those 17 patients operated for o steolysis than those 50 patients with a pathological fracture (P<0.01 and P<0.07, respectively). There were seven hospital deaths. Postopera tive survival time averaged 13.4 months. 41 of the 60 patients dischar ged to outpatient follow-up were again capable of leading a normal lif e, 13 were clearly impaired, six required nursing care. 46 patients di d not or only sporadically require analgesics postoperatively. Conclus ion: Early operative treatment of osteolysis before the occurrence of fractures is justified by the low operative mortality and complication rates and the better quality of life that is achieved.