Beyond Mirels: Factors Influencing Surgical Outcome of Metastasis to the Extremities in the Modern Era
Mirels scoring system for determining prophylactic stabilization need of skeletal metastases includes
a limited number of variables and does not differentiate between procedure types. This study sought
to identify additional variables associated with surgical failure, radiographic disease progression, and
patient survival. A retrospective review was performed of patients from January 2004 to 2014 who
underwent surgical treatment of skeletal metastases of the extremities, were >18 years of age, and had
adequate radiographic surveillance. Eighty-nine metastatic bone lesions in 77 patients were included. Mirels score >8 (p = .015) and tumor origin (p = .008) were associated with surgical failure, which was 16.8%. Male gender (p < .001) and use of bone cement (p = .019) were associated with radiographic progression, 43.8% overall. Antiresorptive medications usage (p = .02) was associated with survival. The study concluded that tumor origin may be highly important when considering surgical treatment for metastatic bone disease and antiresorptive medications should be used postoperatively, given an association with survival. (Journal of Surgical Orthopaedic Advances 27(3):178–186, 2018)
Key words: complications, extremity metastasis, metastatic disease, Mirels criteria, patient survival, surgery
Privacy & Cookies Policy
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.