Hemiarthroplasty for Elderly With Proximal Humeral Mets

NCT07471022 | Completed

• 1 other identifier: 2025-522
• Study Type: observational
• Target: 53
• Locations: 0 countries
• Sites: N/A

Brief Summary

Bone metastases are common in patients with advanced cancer and frequently involve the proximal humerus, leading to severe pain and loss of shoulder function. Shoulder arthroplasty is an important surgical option for restoring limb function and relieving pain in these patients. However, elderly patients often have multiple comorbidities, and it remains unclear whether age affects surgical outcomes and prognosis after arthroplasty for proximal humeral metastases. This retrospective observational study reviewed patients with isolated proximal humeral metastases who underwent shoulder arthroplasty at our institution. Patients were divided into elderly and younger groups based on age, and clinical outcomes were compared between the groups. Evaluated outcomes included operative characteristics, postoperative pain, limb function, complications, survival, recurrence, and quality of life. The aim of this study is to determine whether age influences prognosis and functional recovery after shoulder arthroplasty for proximal humeral metastases, and to assess the feasibility and effectiveness of this surgical procedure in elderly patients.

Conditions

Bone Metastases of a Malignant Tumor; Metastatic Bone Tumor

Keywords

Proximal Humeral Metastases; Bone Metastases; Hemiarthroplasty; Shoulder Arthroplasty; Elderly Patients

Outcome Measures

Primary Outcomes (1)

• (ASES) Score

  Shoulder Function Assessed by the American Shoulder and Elbow Surgeons (ASES) Score

  Postoperative follow-up (up to 24 months)

Study Arms (2)

Elderly Patients (≥65 Years)

Patients aged 65 years or older with solitary proximal humeral metastases who underwent proximal humeral hemiarthroplasty at our institution.

Procedure: Proximal Humeral Hemiarthroplasty

Younger Patients (<65 Years)

Patients younger than 65 years with solitary proximal humeral metastases who underwent proximal humeral hemiarthroplasty at our institution.

Procedure: Proximal Humeral Hemiarthroplasty

Interventions

Proximal Humeral Hemiarthroplasty PROCEDURE

Patients underwent wide tumor excision followed by proximal humeral hemiarthroplasty. En bloc resection was performed according to tumor-free principles, with preservation of the axillary nerve and deltoid muscle whenever possible. Osteotomy was performed 2-3 cm distal to the tumor margin. A tumor-specific prosthesis was implanted and soft tissues were reconstructed. A Ligament Advanced Reinforcement System (LARS) was used when necessary to improve joint stability.

Elderly Patients (≥65 Years); Younger Patients (<65 Years)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study included adult patients with solitary proximal humeral metastases who underwent proximal humeral hemiarthroplasty at our institution between 2013 and 2021. Both male and female patients were eligible. Patients were divided into two groups based on age (≥65 years and \<65 years) to compare surgical outcomes, functional recovery, complications, and survival. All patients had confirmed metastatic bone tumors, with lesions localized to the proximal humerus and without involvement of the scapula or axillary nerve. Patients with multiple bone metastases or severe comorbidities were excluded.

You may qualify if:

• Patients with a single metastatic lesion in the proximal humerus, confirmed by imaging or biopsy.
• Presence of pathological fracture or a severe osteolytic lesion at risk of fracture (Mirels score ≥9).
• Poor response to radiotherapy according to RECIST 1.1 criteria.
• Persistent severe shoulder pain or significant loss of shoulder function.
• Estimated life expectancy \>3 months at the time of surgery..

You may not qualify if:

• Patients with multiple bone metastases involving two or more skeletal sites.
• Metastatic lesions affecting the scapula, axillary nerve, or brachial plexus.
• Death during the perioperative period.
• Presence of three or more significant comorbidities, such as uncontrolled diabetes, severe cardiopulmonary disease, or chronic renal failure.
• Loss to follow-up within 3 months after surgery.

Sponsors & Collaborators

• Sichuan Provincial People's Hospital: lead

MeSH Terms

Conditions

Bone Neoplasms

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Bone Diseases; Musculoskeletal Diseases

Study Officials

• Ji Zhou

  Sichuan Provincial People's Hospital

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, PhD

Study Record Dates

• First Submitted: March 10, 2026
• First Posted: March 13, 2026
• Study Start: January 1, 2013
• Primary Completion: December 31, 2021
• Study Completion: September 4, 2025
• Last Updated: March 13, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share