Trends in Diagnosis and Surgical Treatment of Bone Metastases among Orthopedic Surgeons

Abstract

Background: The proper diagnosis and treatment of bone metastases are essential for patient survival. However, several strategies for the treatment are practiced. Therefore, the aim of the study was to analyze what factors influence the choice of a method of treatment. Methods: An online survey was conducted within the Polish Society of Orthopedics and Traumatology. It consisted of 45 questions and was divided into four main parts: Participant Characteristics, Diagnosis and Qualification, Treatment, and Clinical Cases. Results: A total number of 104 responses were collected. The most frequently chosen methods were: Intramedullary nail (IMN) + Resection + Polymethyl methacrylate (PMMA) (30.47%) and IMN without tumor resection (42.13%), and in third place, modular endoprosthesis (17.25%). The less experienced group of orthopedic surgeons more often (47.5% vs. 39.5%) decided to perform IMN without tumor resection than the more experienced group (p = 0.046). Surgeons from district hospitals less frequently (13.7% vs. 23.1%) would decide to use modular endoprosthesis than surgeons from university hospitals (p = 0.000076). Orthopedists who performed ≥ 11 bone metastases surgeries per year would more often use modular endoprosthesis (34.8% vs. 13.2%) than those who performed ≤ 10 operations per year (p = 0.000114). Conclusion: Experience, place of work, and the number of metastasis surgeries performed during a year may influence the choice of treatment method in patients with bone metastases.

Electrochemotherapy in the Treatment of Bone Metastases: A Systematic Review

“…Patients with metastatic bone disease are evaluated by a team that includes oncologists, radiation oncologists, and orthopedists. The treatment of metastatic lesions depends on various factors including the patient's life expectancy, general condition, number of metastases, progression of neoplastic disease, sensitivity to treatment, presence of a pathologic fracture, the patient's quality of life [5,6], and the use of scores such as the Mirel Score [7]. There are various types of treatment for patients with bone metastases.…”