Evaluation of the feasibility of and results of measuring health-status changes in patients undergoing surgical treatment for skeletal metastases

The goal of treating patients with skeletal metastases is to decrease pain and improve or maintain physical function. Assessment of the effectiveness of treatment should therefore include evaluation of patient-rated measures of quality of life. The primary objective of the study was to determine the feasibility of studying the effect of surgical treatment of skeletal metas tases on quality of life. The secondary objective was to provide data that begin to characterize this effect. The characteristics of patients with ske letal metastases are heterogeneous, patient enrollment in the study may be low, high attrition occurs secondary to death, and well accepted health-sta tus measures (such as the Short Form-36) may be ineffective at detecting ch anges in health status; therefore, it is difficult to study these patients. High attrition and adjuvant treatment with radiation or chemotherapy made it impractical to draw firm conclusions about the effect of surgical treatm ent, but a trend toward improvement in selected health-status measures for both physical and mental health was noted. Analysis of patient-rated health -status scores as predictors of survival indicates that improvement in thes e scores 6 weeks after surgery is associated with an increase in the length of survival following surgery.