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Metastases to the Long Bones: Algorithm of Treatment

  • Maurizio Scorianz
  • Franco Gherlinzoni
  • Domenico A. Campanacci
Chapter

Abstract

Metastases of the long bones represent a frequent clinical condition.

Multiple treatment options are available, ranging from the more aggressive resections and arthroplasty to palliative care and from long-lasting reconstruction to minimally invasive therapies.

When selecting a treatment, it is paramount to consider not only the mechanical characteristics of the lesions but also the tumoral behavior, medical state, and expected survival of the patient. In addition, other factors should be taken into account: the presence of a single metastatic lesion, the site in the long bone (diaphysis or metaepiphysis), mechanical stability (impending or pathological fracture), and the effectiveness of nonsurgical therapies.

Several prognostic criteria were assessed in the last 20 years and, being familiar with them may help in treatment selection.

An algorithm of treatment has been the objective to guide the decision-making process in a multidisciplinary approach to metastasis of the long bones.

A collaboration between the orthopedic surgeon, the oncologist, and the radiotherapist leads to the best choice of treatment for the different scenarios.

Keywords

Metastases Long bones Algorithm Metastases resection Osteosynthesis Palliative therapy 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Maurizio Scorianz
    • 1
  • Franco Gherlinzoni
    • 2
  • Domenico A. Campanacci
    • 1
    • 3
  1. 1.Orthopaedic Oncology and Reconstructive UnitCareggi University HospitalFlorenceItaly
  2. 2.Orthopedic and Traumatology UnitGorizia General HospitalGoriziaItaly
  3. 3.Department of Surgery and Translational MedicineUniversity of FlorenceFlorenceItaly

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