The benefit of surgical management of colorectal carcinoma bone metastases
Bibliographic record
Abstract
Background/Objective: Metastatic colorectal carcinoma to bone rarely requires surgical intervention, and is infrequently studied. Aggressive surgical resection is sometimes empirically recommended in these patients, although there is no proven benefit for patient survival. Our hypothesis was that there is survival advantage conferred by resecting bone metastases (BM) when surgery is necessary. Methods: We performed a retrospective review of a prospectively collected database and identified 39 patients with bone metastases in the appendicular skeleton requiring surgery. Patients underwent surgery because of intractable pain, impending pathologic fracture, and/or pathologic fracture at presentation. Results: Median survival after complete resection of bone metastasis was higher (8 months) than for patients who had surgery, but did not have bony metastases completely excised (3 months, p = 0.014); and in surgical patients who had solitary bone metastasis at presentation ( p = 0.023) compared with multiple bone involvement. There were no perioperative deaths. Additional skeletal surgeries were only required for patients (4 out of 39) with local recurrences. In cases of local recurrence, the median time to progression was 19 months. Conclusions: Surgery for bone metastasis in colorectal carcinoma is well tolerated, and can be considered for palliative care. Compared with other surgical techniques, complete bone-metastasis resection is associated with longer overall survival, and with longer recurrence free survival.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".