Ishibashi Y, Nakazato K, Tachibana N, Yu J, Ugawa S, Asanuma Y, Kusunoki Y, Hasebe S, Takahashi T, Hara N. Prognostic factors for patients undergoing surgery for femur metastases following systemic treatment. World J Orthop 2026; 17(5): 116525 [DOI: 10.5312/wjo.v17.i5.116525]
Corresponding Author of This Article
Yuki Ishibashi, MD, Department of Orthopaedic Surgery, Japanese Red Cross Musashino Hospital, 1-26-1 Sakaiminatocho, Musashino 180-0023, Tokyo, Japan. yuki19861024@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Cohort Study
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Ishibashi Y, Nakazato K, Tachibana N, Yu J, Ugawa S, Asanuma Y, Kusunoki Y, Hasebe S, Takahashi T, Hara N. Prognostic factors for patients undergoing surgery for femur metastases following systemic treatment. World J Orthop 2026; 17(5): 116525 [DOI: 10.5312/wjo.v17.i5.116525]
Yuki Ishibashi, Keiu Nakazato, Naohiro Tachibana, Jim Yu, Satomi Ugawa, Yuki Asanuma, Yusuke Kusunoki, Sho Hasebe, Tomoshi Takahashi, Nobuhiro Hara, Department of Orthopaedic Surgery, Japanese Red Cross Musashino Hospital, Musashino 180-0023, Tokyo, Japan
Author contributions: Ishibashi Y wrote the manuscript and reviewed the relevant literature; Nakazato K, Tachibana N, Yu J, Ugawa S, Asanuma Y, Kusunoki Y, Hasebe S, Takahashi T, and Hara N contributed to the conception and design of the study, and critically revised the manuscript. All the authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the institutional review board of our hospital (approval No. 7027). All study procedures were performed in accordance with the ethical standards of the Helsinki Declaration of 1975 (as revised in 2000) and national law.
Informed consent statement: Our consent is opt-out and there is no individual consent form.
Conflict-of-interest statement: The authors declare no conflicts of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data sharing is not applicable to this article as no new data were created or analyzed in this study.
Corresponding author: Yuki Ishibashi, MD, Department of Orthopaedic Surgery, Japanese Red Cross Musashino Hospital, 1-26-1 Sakaiminatocho, Musashino 180-0023, Tokyo, Japan. yuki19861024@gmail.com
Received: November 14, 2025 Revised: December 19, 2025 Accepted: February 6, 2026 Published online: May 18, 2026 Processing time: 186 Days and 6.8 Hours
Abstract
BACKGROUND
Patients with bone metastases often receive systemic treatments, including hormone and anti-cancer drug therapies. Systemic treatment may also be considered while planning for surgery. Consequently, accurate prognostic data and survival estimates for patients with bone metastases are indispensable for recommending the most appropriate treatment strategies.
AIM
To examined the prognosis and prognostic predictors in patients who received systemic treatment before surgery for femoral metastases.
METHODS
This retrospective cohort study included 24 patients who underwent surgery for femoral metastasis by orthopedic doctors and received preoperative systemic therapy at our hospital between 2014 and 2024. Kaplan-Meier analysis and Cox proportional hazards regression were employed to assess the relationship between overall survival (OS) and clinical parameters, including serum biochemical concentrations and blood cell counts.
RESULTS
Fourteen patients underwent postoperative systemic treatment. The median OS was 6 months [95% confidence interval (CI): 4-15 months], and the 1-year survival rate was 35%. Of the 24 patients, 17 were followed up until death. The multivariate analysis revealed that the administration of systemic treatment after surgery (hazard ratio, 0.27; 95%CI: 0.085-0.85, P = 0.025) was significantly associated with a favorable OS.
CONCLUSION
Orthopedic doctors should take into consideration that administering systemic treatment postoperatively may improve the prognosis of patients undergoing surgery for femoral metastasis who have also received preoperative systemic treatment.
Core Tip: This retrospective cohort study included 24 patients who underwent surgery for femoral metastasis by orthopedic doctors and received preoperative systemic therapy. We investigated the relationship between overall survival and clinical parameters, including serum biochemical concentrations and blood cell counts. Administering systemic treatment after surgery may be a favorable prognostic factor in patients undergoing surgery for femoral metastasis who have also received preoperative systemic treatment.
