Metastases to the hand and wrist: An analysis of 221 cases

To identify demographic trends, survival rates, the most common metastatic locations,
and the most common primary malignant tumors in the reports of hand and wrist
metastases published over the past 27 years.
Methods A keyword search was performed across PubMed, Google, Science Direct, and
Springer databases with a time-range restriction set between April 1986 and April 2013. A
total of 193 articles were located describing 221 patients. The data were analyzed for patient
age, sex, known history of malignancy, primary tumor site, histological diagnosis, metastatic
location, hand involvement, and survival rates.
Results Lung, gastrointestinal tract, and kidney malignancies were the 3 leading metastatic tumors.
The mean age among patients was 61�13 years, and involvement among men was almost
twice as common as among women. The mean survival from the time of the diagnosis was
7�7 months. There were no predilections for either the right or the left hand. The distal phalanx
was the most frequently involved bone, and the thumb was the most frequently involved digit.
Conclusions The frequency of published hand and wrist metastasis has increased dramatically
within the last decade. Metastases have been reported for every bone of the hand and wrist as
well as for the soft tissues. Compared with the previous studies, the mean age of reported
patients has slightly increased even though the mean survival time has not changed.