我们首先试图比较接受手术治疗的阑尾骨骼孤立性和多发性骨转移患者的生存率，其次探讨完全和不完全切除（R0和R1/R2）对阑尾骨骼孤立性骨转移患者的作用我们对 2014 年 1 月至 2019 年 12 月期间接受阑尾骨骨转移手术治疗的所有成年患者进行了一项基于人群的回顾性研究。我们排除了骨转移和切除边缘状况未知的患者。对患者进行随访直至研究结束或死亡。我们没有损失后续行动。我们使用 Kaplan-Meier 分析（带有对数秩检验）来评估患者的生存率。我们确定了 459 名患者接受了 506 次手术。总共有 120 例手术（116 名患者）针对单发性转移瘤，386 例手术（345 名患者）针对多发性转移瘤。在 120 例手术中，70 例（69 例患者）没有/未知内脏转移状态（孤立组），50 例（49 例患者）有内脏转移。在单独组中，45 例手术（44 名患者）为 R0（治愈或完全缓解切除），25 例手术（25 名患者）为 R1/R2（分别留下微观或宏观肿瘤的切除）。孤立组中最常见的癌症类型是肾癌 (n = 27)、肺癌 (n = 25) 和乳腺癌 (n = 20)。患者一年生存率为 47%（95% 置信区间 (CI)）对于单发性骨转移，该比例为 38 至 57）；对于多发性骨转移，该比例为 34%（95% CI 29 至 39）（p < 0.001）。无/有未知内脏转移的孤立性骨转移患者的一年患者生存率为 64% (95% CI 52 - 75)，有内脏转移的孤立性骨转移患者的一年生存率为 23% (95% CI 11 - 36) (p < 0.001) 。 R0 手术后孤立性骨转移患者的一年患者生存率为 75%（95% CI 62 至 89），R1/R2 手术后孤立性骨转移患者的一年生存率为 42%（95% CI 22 至 61）（p < 0.001） ）。我们的研究表明，对阑尾骨骼孤立性骨转移的患者进行手术治疗比多发性骨转移患者的生存率更高。此外，通过 R0 手术积极治疗孤立性骨转移可能会提高患者的生存率。© 2023 英国骨科编辑协会

We first sought to compare survival for patients treated surgically for solitary and multiple metastases in the appendicular skeleton, and second, to explore the role of complete and incomplete resection (R0 and R1/R2) in patients with a solitary bony metastasis in the appendicular skeleton.We conducted a retrospective study on a population-based cohort of all adult patients treated surgically for bony metastases of the appendicular skeleton between January 2014 and December 2019. We excluded patients in whom the status of bone metastases and resection margin was unknown. Patients were followed until the end of the study or to their death. We had no loss to follow-up. We used Kaplan-Meier analysis (with log-rank test) to evaluate patient survival. We identified 506 operations in 459 patients. A total of 120 operations (in 116 patients) were for solitary metastases and 386 (in 345 patients) for multiple metastases. Of the 120 operations, 70 (in 69 patients) had no/an unknown status of visceral metastases (solitary group) and 50 (in 49 patients) had visceral metastases. In the solitary group, 45 operations (in 44 patients) were R0 (resections for cure or complete remission) and 25 (in 25 patients) were R1/R2 (resections leaving microscopic or macroscopic tumour, respectively). The most common types of cancer in the solitary group were kidney (n = 27), lung (n = 25), and breast (n = 20).The one-year patient survival was 47% (95% confidence interval (CI) 38 to 57) for the solitary bony metastases and 34% (95% CI 29 to 39) for multiple bone metastases (p < 0.001). The one-year patient survival was 64% (95% CI 52 to 75) for solitary bony metastases without/with unknown visceral metastases and 23% (95% CI 11 to 36) for solitary bony metastases with visceral metastases (p < 0.001). The one-year patient survival was 75% (95% CI 62 to 89) for a solitary bony metastasis after R0 surgery and 42% (95% CI 22 to 61) for a solitary bony metastasis with R1/R2 surgery (p < 0.001).Our study suggests that the surgical treatment of patients with a solitary bony metastasis to the appendicular skeleton results in better survival than for patients with multiple bony metastases. Furthermore, aggressive treatment of a solitary bony metastasis with R0 surgery may improve patient survival.© 2023 The British Editorial Society of Bone & Joint Surgery.