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What Is New in Management of Bone Metastases

  • Costantino Errani
  • Davide Maria Donati
Chapter

Abstract

Metastatic tumors are the most common malignancy of the bone. Traditional management techniques involve a combination of pharmacotherapy, radiotherapy, and surgical procedures. Novel medical treatments combined with less invasive surgical procedures can offer an effective palliative option in patients with limited life expectancy. Denosumab, a monoclonal antibody targeting receptor activator of nuclear factor kappa-B ligand (RANKL), was found to be a promising new therapeutic strategy for patients with bone metastases by restricting bone destruction. However, the scientific community should be aware of the possible association of denosumab treatment with occurrence of new malignancies.

Advancements in surgical techniques have led to the development of the concept of less invasive surgical procedures with the aim of achieving the same clinical results with less morbidity related to the surgical approach. Less invasive procedures include the following: endoscopic surgery, computer-assisted surgery, and minimally invasive percutaneous surgery. Benefits of less invasive techniques include decreased blood loss, less postoperative pain, and shortened recovery time. Less invasive procedures also allow earlier initiation of postoperative adjuvant treatments. Considering the limited expectancy of most patients with bone metastases, the main goal of novel medical and surgical treatments is to improve the quality of life of patients with bone metastases reducing the adverse effects related to the traditional medical or surgical treatments.

Keywords

Bone metastases Novel therapies Denosumab Endoscopic surgery Computer-assisted surgery Minimally invasive percutaneous surgery 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Orthopaedic ServiceIstituto Ortopedico RizzoliBolognaItaly

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