Analysis of bone metastasis multidisciplinary team meeting activity in a university hospital: patient profiles, prognostic factors

Abstract

Bone metastases a represent a challenge in the oncological management of patients as the complications can be severe, as fractures or neurological impairment in spinal metastases. Recommendations on the management of bone metastases are constantly being improved. However, there are few recent prognostic data on bone metastases in the literature to assess the impact of advances in oncological treatment on patient survival. An analysis of the activity of an MDT (Multidisciplinary Team Meeting) over 2 years could provide recent data regarding prognosis of patients presenting with bone metastasis. This is a retrospective study of patients presented at an MDT from 2020 to 2021 in a university hospital. The objectives were to describe a representative cohort of patients with bone metastasis and the therapeutic decisions made (cementoplasty/radiotherapy/surgery) and patient survival according to tumor type, location of bone metastasis (spine/pelvis/other). Nine hundred ninety-two presentations of 630 patients were analyzed. The most frequent primary cancer was bronchopulmonary, followed by breast, myeloma, prostate and thyroid. 85% of patients had a spinal lesion, 51% a pelvic lesion and 52% another bone site. 49% of patients underwent radiotherapy, 39% cementoplasty and 22% surgery. Median survival was 17 months. Bronchopulmonary and prostate tumors patients had a poorer prognosis. 37% of operated patients died within 6 months of follow-up. This study provides a description of bone MDT meeting activity in a university hospital setting, and gives a picture of the volume of activity, prognostic factors and decisions taken with significant recourse to cementoplasty, compared with older series. The presence of bone metastases still represents a turning point in the progression of oncological diseases. IV, retrospective study.