<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282025000100024</article-id>
<article-id pub-id-type="doi">10.29315/gm.806</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Preventing Proximal Femur Pathologic Fractures Improves Outcomes in Patients with Metastatic Bone Disease: A Clinical Study Based on a Single Center Experience]]></article-title>
<article-title xml:lang="pt"><![CDATA[A Prevenção de Fraturas Patológicas do Fémur Proximal Otimiza Resultados Clínicos em Doentes com Doença Óssea Metastática: Um Estudo Clínico Baseado na Experiência de um Centro]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinheiro]]></surname>
<given-names><![CDATA[Joana Páscoa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nabais]]></surname>
<given-names><![CDATA[Mariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Spranger]]></surname>
<given-names><![CDATA[André]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[Paulo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Portela]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brito]]></surname>
<given-names><![CDATA[Joaquim Soares do]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário Lisboa Norte Hospital de Santa Maria Orthopedics and Trauma Department]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2025</year>
</pub-date>
<volume>12</volume>
<numero>1</numero>
<fpage>24</fpage>
<lpage>31</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282025000100024&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282025000100024&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282025000100024&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Metastatic bone disease decreases a patient&#8217;s function and increases morbidity being frequently found in patients with solid malignant tumors and multiple myeloma (MM). The effective treatment of these patients demands a multidisciplinary team approach to prevent catastrophic events such as pathologic fractures, especially in the proximal femur. This study aimed to evaluate oncologic outcomes, surgical complications, and associated healthcare costs in surgically treated patients with proximal femur bone metastases.  Methods:  Retrospective study (2017-2021) of patients with proximal femur bone metastases secondary to carcinomas or MM, where surgical treatment of that anatomic location was performed. Epidemiologic data, histology, surgical management, presence of pathologic fracture, length of stay and overall survival were evaluated based on clinical records. Data analyses were performed using SPSS 23.0.  Results:  Thirty-seven patients were identified, 20 male and 17 female. Nine patients had lung cancer metastases, eight had breast cancer metastases, seven had prostatic cancer secondary lesions, four presented uterine cancer secondary lesions, three cases were secondary to kidney cancer, and six patients had MM lesions. Twenty-nine patients presented pathologic fractures, while eight had an impending fracture. Twenty-six patients underwent osteosynthesis or conventional hemiarthroplasty/total hip arthroplasty, while an en bloc resection with megaprosthetic reconstruction was performed in the remaining 11 cases. Length of stay was longer for patients with pathologic fractures (p&lt;0.05), with a better one-year overall survival (OS) for those with breast cancer metastases, those who underwent en bloc resection and those with impending fractures (p&lt;0.05).  Conclusion:  OS for patients with proximal femoral metastases seems to be influenced by primary tumor histology, type of surgical management and the presence of pathologic fracture at diagnosis. This evidence should encourage thorough periodic follow-ups to prevent pathologic fractures and achieve optimized outcomes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A doença metastática óssea reduz a qualidade de vida e condiciona a capacidade funcional dos doentes, ocorrendo com maior frequência em tumores sólidos malignos e mieloma múltiplo (MM). O tratamento eficaz exige uma abordagem multidisciplinar de forma a prevenir eventos catastróficos como fraturas patológicas, especialmente no fémur proximal. O objetivo deste estudo foi avaliar os resultados oncológicos, complicações cirúrgicas e custos de saúde associados ao tratamento cirúrgico de doentes com metástases ósseas do fémur proximal.  Métodos:  Estudo retrospetivo (2017-2021) de doentes com metástases localizadas no fémur proximal, secundárias a carcinomas ou MM, submetidos a tratamento cirúrgico desse segmento anatómico. Foram analisados dados epidemiológicos, histológicos, estratégia cirúrgica adotada, presença ou não de fratura patológica, tempo de internamento e sobrevida global dos doentes, recorrendo aos registos em processo clínico. Os dados coletados foram tratados estatisticamente recorrendo ao SPSS 23.0.  Resultados:  Foram identificados 37 doentes, sendo 20 do género masculino e 17 do género feminino. Nove doentes apresentaram metástases secundárias a carcinoma do pulmão, oito a carcinoma da mama, sete a carcinoma da próstata, quatro a carcinoma do útero, três a carcinoma do rim, e seis doentes tinham lesões secundárias a MM. Vinte e nove apresentavam fratura patológica, enquanto oito foram operados por fratura iminente. Enquanto 26 casos foram submetidos a osteossíntese ou hemiartroplastia/artroplastia total convencional da anca, 11 foram submetidos a resseção em bloco e reconstrução com megaprótese. O tempo médio de internamento foi superior nos doentes com fraturas patológicas (p&lt;0,05), com a sobrevida global (SG) ao final de um ano superior nos doentes com metástases de carcinoma da mama, naqueles submetidos a resseção em bloco e para os tratados com fratura eminente (p&lt;0,05).  Conclusão:  A SG em doentes com metástases do fémur proximal parece ser influenciada pela histologia do tumor primário, tipo de tratamento cirúrgico e pela presença de fratura patológica ao diagnóstico. Esta evidência deve encorajar um seguimento vocacionado para a prevenção das fraturas patológicas em doentes com metástases no fémur proximal, e sempre que possível promover resseções oncológicas.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Fracturas do Fémur/prevenção e controlo]]></kwd>
<kwd lng="pt"><![CDATA[Fracturas Espontâneas/prevenção e controlo]]></kwd>
<kwd lng="pt"><![CDATA[Neoplasias Ósseas/complicações]]></kwd>
<kwd lng="pt"><![CDATA[Neoplasias Ósseas/secundárias.]]></kwd>
<kwd lng="en"><![CDATA[Bone Neoplasms/ complications]]></kwd>
<kwd lng="en"><![CDATA[Bone Neoplasms/secondary]]></kwd>
<kwd lng="en"><![CDATA[Femoral Fractures/prevention &amp; control]]></kwd>
<kwd lng="en"><![CDATA[Fractures, Spontaneous/prevention &amp; control.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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