Evaluation of the feasibility of and results of measuring health-status changes in patients undergoing surgical treatment for skeletal metastases

The goal of treating patients with skeletal metastases is to decrease pain and improve or maintain physical function. Assessment of the effectiveness of treatment should thcrelore include evaluation of patientrated measures of qualily ol life. The primary objective of the study was to dctcrmine the feasibility of studying the effect of surgical treatment of skeletal metastases on quality of lifc. The secondary objective was to provide data that begin to characterize this effect. The characteristics of paticnls with skeletal metastases are heterogeneous. paticnt enrollment in the study may be low. high attrition occurs secondary to death, and well acccpted health-status measures (such as the Short Form-36) may be ineffective at detecting changes in health status; therefore, it is difficult to study these patients. High attrition aiid adjuvant treatment with radiation or chemotherapy made it impractical to draw firm conclusions about the effccl ol surgical treatment, but a trend toward improvement in selected health-status measures for both physical and mental health was noted. Analysis of patient-rated health-status scores as predictors of survival indicates that improvement in these scores 6 weeks after surgery is associated with an increase in the length of survival following surgery.