Length of Time to Clinical Improvement After Orthopedic Oncology Surgery in Patients With Metastatic Cancer: A Multi-Institution Patient-Reported Outcome Study

BackgroundCurrently, there is a paucity of data that describes the length of time required to realize improvement in pain and function following surgery for patients with metastatic cancer to bone.MethodsOne hundred patients with impending or completed pathologic fractures due to metastatic cancer to bone were enrolled in this prospective cohort study. Outcomes were measured with a Computer Adaptive Test of Patient Reported Outcomes for Pain Interference and Physical Function domains, to determine the time required to achieve a Minimal Clinically Important Difference (MCID) in the tested domains.ResultsEighty-one patients were included in the analysis. Thirty-two patients (39.5%) survived and completed the follow-up to 1 year, while 23 (28.4%) died before the end of the data collection. Fifty-one patients (63.0%) achieved at least a 5-point improvement in Physical Function and 59 (72.8%) achieved at least a 5-point improvement in Pain Interference. The time to achieve the MCID was 6 weeks for the Physical Function and 4 weeks for the Pain Interference domain.ConclusionThe majority of patients with impending or completed pathologic fractures due to metastatic cancer see clinically important improvements in pain and function after surgery in an average of 4 and 6 weeks, respectively.