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Letter to the Editor regarding "Questionable indication for postoperative radiotherapy after surgery for metastases of the major long bones": A cautionary note on methodology and analysis.

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Title: Letter to the Editor regarding "Questionable indication for postoperative radiotherapy after surgery for metastases of the major long bones": A cautionary note on methodology and analysis.
Authors: Lee SF; Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.; Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.; Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences Monash University, Clayton, Victoria, Australia., Finkelstein JA; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada., Hoskin PJ; Mount Vernon Cancer Centre, Northwood, UK.; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK., Rades D; Department of Radiation Oncology, University of Lübeck, Lübeck, Germany., Oldenburger E; Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium., Balboni TA; Department of Radiation Oncology, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, USA., Roos DE; Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.; School of Medicine, University of Adelaide, Adelaide, South Australia, Australia., Kreder H; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada., Chang EL; Department of Radiation Oncology, The University of Texas, M D Anderson Cancer Center, Houston, TX, USA., Ryu S; Department of Radiation Oncology, Stony Brook University Health Science Center, Stony Brook, NY, USA., Khoury A; Division of Orthopedics, Tel Aviv Sourasky Medical Center, Tel-Aviv, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Dennis K; Division of Radiation Oncology, Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada., Johnstone C; Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA., Alcorn SR; Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA., Simone CB 2nd; New York Proton Center, New York, NY, USA.; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Brown S; Norfolk and Norwich University Hospital, UK., Willmann J; Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland., van der Velden JM; Department of Radiotherapy, Leiden University Medical Centre, the Netherlands.; Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands., Spałek M; Department of Soft Tissue/Bone Sarcoma and Melanoma and Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland., van der Linden YM; Department of Radiotherapy, Leiden University Medical Centre, the Netherlands.; Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, the Netherlands., Kazmierska J; Radiotherapy Department II, Greater Poland Cancer Centre, Poznan, Poland.; Electroradiology Department, University of Medical Sciences, Poznan, Poland., Andratschke N; Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland., Martin EJ; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA., Chao M; Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.; Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences Monash University, Clayton, Victoria, Australia.; Genesis Care Victoria, Ringwood Private Hospital, Ringwood East, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia., Soliman H; Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada., Kwan K; Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China., Yau RCH; Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China., Yu S; Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China., Li Z; Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China., Yee A; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada., Lu N; Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.; Beijing Key Laboratory of Urologic Cancer Cell and Gene Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China., Zhang X; Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China., Jones GP; UMass Memorial Medical Group, Worcester, MA, USA., Chan WL; Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China., Chan AW; Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, Canada., Chan CM; Hand and Reconstructive Microsurgery, National University Hospital, Singapore., Rembielak A; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.; Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK., Marta GN; Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil.; Latin American Cooperative Oncology Group (LACOG), Brazil., Vassiliou V; Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus., Caini S; Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy., Chow E; Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada., Wong HCY; Department of Oncology, Princess Margaret Hospital, Hong Kong.
Source: Journal of bone oncology [J Bone Oncol] 2026 Mar 29; Vol. 58, pp. 100757. Date of Electronic Publication: 2026 Mar 29 (Print Publication: 2026).
Publication Type: Editorial
Journal Info: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101610292 Publication Model: eCollection Cited Medium: Print ISSN: 2212-1366 (Print) Linking ISSN: 22121366 NLM ISO Abbreviation: J Bone Oncol Subsets: PubMed not MEDLINE
Database: MEDLINE Ultimate
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  Data: Letter to the Editor regarding "Questionable indication for postoperative radiotherapy after surgery for metastases of the major long bones": A cautionary note on methodology and analysis.
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  Data: <searchLink fieldCode="AU" term="%22Lee+SF%22">Lee SF</searchLink>; Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.; Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.; Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences Monash University, Clayton, Victoria, Australia.<br /><searchLink fieldCode="AU" term="%22Finkelstein+JA%22">Finkelstein JA</searchLink>; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Hoskin+PJ%22">Hoskin PJ</searchLink>; Mount Vernon Cancer Centre, Northwood, UK.; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.<br /><searchLink fieldCode="AU" term="%22Rades+D%22">Rades D</searchLink>; Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.<br /><searchLink fieldCode="AU" term="%22Oldenburger+E%22">Oldenburger E</searchLink>; Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium.<br /><searchLink fieldCode="AU" term="%22Balboni+TA%22">Balboni TA</searchLink>; Department of Radiation Oncology, Brigham and Women's Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, USA.<br /><searchLink fieldCode="AU" term="%22Roos+DE%22">Roos DE</searchLink>; Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.; School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.<br /><searchLink fieldCode="AU" term="%22Kreder+H%22">Kreder H</searchLink>; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Chang+EL%22">Chang EL</searchLink>; Department of Radiation Oncology, The University of Texas, M D Anderson Cancer Center, Houston, TX, USA.<br /><searchLink fieldCode="AU" term="%22Ryu+S%22">Ryu S</searchLink>; 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Norfolk and Norwich University Hospital, UK.<br /><searchLink fieldCode="AU" term="%22Willmann+J%22">Willmann J</searchLink>; Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.<br /><searchLink fieldCode="AU" term="%22van+der+Velden+JM%22">van der Velden JM</searchLink>; Department of Radiotherapy, Leiden University Medical Centre, the Netherlands.; Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.<br /><searchLink fieldCode="AU" term="%22Spałek+M%22">Spałek M</searchLink>; Department of Soft Tissue/Bone Sarcoma and Melanoma and Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.<br /><searchLink fieldCode="AU" term="%22van+der+Linden+YM%22">van der Linden YM</searchLink>; Department of Radiotherapy, Leiden University Medical Centre, the Netherlands.; Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, the Netherlands.<br /><searchLink fieldCode="AU" term="%22Kazmierska+J%22">Kazmierska J</searchLink>; Radiotherapy Department II, Greater Poland Cancer Centre, Poznan, Poland.; Electroradiology Department, University of Medical Sciences, Poznan, Poland.<br /><searchLink fieldCode="AU" term="%22Andratschke+N%22">Andratschke N</searchLink>; Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.<br /><searchLink fieldCode="AU" term="%22Martin+EJ%22">Martin EJ</searchLink>; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.<br /><searchLink fieldCode="AU" term="%22Chao+M%22">Chao M</searchLink>; Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.; Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences Monash University, Clayton, Victoria, Australia.; Genesis Care Victoria, Ringwood Private Hospital, Ringwood East, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.<br /><searchLink fieldCode="AU" term="%22Soliman+H%22">Soliman H</searchLink>; Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Kwan+K%22">Kwan K</searchLink>; Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.<br /><searchLink fieldCode="AU" term="%22Yau+RCH%22">Yau RCH</searchLink>; Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.<br /><searchLink fieldCode="AU" term="%22Yu+S%22">Yu S</searchLink>; Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.<br /><searchLink fieldCode="AU" term="%22Li+Z%22">Li Z</searchLink>; Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.<br /><searchLink fieldCode="AU" term="%22Yee+A%22">Yee A</searchLink>; Division of Orthopaedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Lu+N%22">Lu N</searchLink>; Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.; Beijing Key Laboratory of Urologic Cancer Cell and Gene Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.<br /><searchLink fieldCode="AU" term="%22Zhang+X%22">Zhang X</searchLink>; Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.<br /><searchLink fieldCode="AU" term="%22Jones+GP%22">Jones GP</searchLink>; UMass Memorial Medical Group, Worcester, MA, USA.<br /><searchLink fieldCode="AU" term="%22Chan+WL%22">Chan WL</searchLink>; Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.<br /><searchLink fieldCode="AU" term="%22Chan+AW%22">Chan AW</searchLink>; Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, Canada.<br /><searchLink fieldCode="AU" term="%22Chan+CM%22">Chan CM</searchLink>; Hand and Reconstructive Microsurgery, National University Hospital, Singapore.<br /><searchLink fieldCode="AU" term="%22Rembielak+A%22">Rembielak A</searchLink>; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.; Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.<br /><searchLink fieldCode="AU" term="%22Marta+GN%22">Marta GN</searchLink>; Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil.; Latin American Cooperative Oncology Group (LACOG), Brazil.<br /><searchLink fieldCode="AU" term="%22Vassiliou+V%22">Vassiliou V</searchLink>; 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