classification
Tumor
Surgical treatment is an indispensable and important means in the comprehensive treatment of malignant tumors. Its purpose is to benefit patients in both the treatment of primary tumors and the improvement of their quality of life.
More typical breast cancer bone metastases have bone-related events. There is a clear history of breast cancer, abnormal bone scans, X-ray and CT scans clearly indicate bone destruction, which is consistent with the pathological diagnosis of puncture. Because the prognosis of breast cancer is relatively good, for a single bone metastasis that appears during the treatment, the principle of surgical treatment is to completely remove the lesion, combined with medical treatment of the primary tumor, in order to achieve long-term disease-free survival.
There is no history of related tumors, and bone lesions are the first symptom. In the examination of bone lesions, combined with clinical judgments as metastatic lesions, the primary tumors can be detected retrospectively. Because the prognosis of lung cancer is poor, the survival period is short, and severe pain and loss of joint function caused by metastatic fractures are clear indications for surgical treatment. The main purpose of treatment is to improve the quality of life, reduce tumor burden, and control pain. Therefore, immediate and strong internal fixation treatment was adopted for the patient, the motor function of the affected limb was restored after the operation, and the quality of life was significantly improved, which made the patient more dignified and confident, and provided a good foundation for subsequent medical treatment.
According to the characteristics of bone metastases, surgical intervention should grasp certain principles and timing.
Principles of surgical treatment of bone metastases:
①The patient is expected to survive for more than three months; ②The patient's general condition is good and can tolerate surgical trauma and anesthesia; ③It is expected that the patient will have a better quality of life after surgical treatment and be able to move immediately, which is helpful for further treatment and Nursing; ④The patient is expected to have a longer tumor-free survival after the treatment of the primary tumor; ⑤There is an isolated bone metastasis; ⑥The risk of pathological fracture is high.
Timing of surgical intervention:
①The history of cancer, imaging and histological examination showed a single bone metastasis; ②The pathological fracture caused the patient's motor system dysfunction; ③The weight-bearing bone showed bone destruction visible on X-ray film; ④Bone destruction progressed after conservative treatment; ⑤ Pain continued to worsen after conservative treatment; ⑥ motor system function still could not be restored after conservative treatment; ⑦ pathological fracture had occurred; ⑧ symptom of nerve compression; ⑨ osteolytic destruction of the spine, high risk of paraplegia; ⑩ insensitive to radiotherapy and chemotherapy Bone metastases.
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