Special Issue "Treatment of Bone Metastasis"

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Bone and Soft Tissue Oncology".

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editor

Dr. Costantino Errani
E-Mail
Guest Editor
Orthopaedic Service, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Interests: bone tumors; soft tissue tumors; bone sarcomas; soft tissue sarcomas; bone metastases; limb salvage surgery

Special Issue Information

Dear Colleagues,

The incidence of metastatic bone disease is increasing, as patients with cancer are living longer. Bone is the third most common site of metastatic disease, after the lungs and the liver. Long bone metastases are a common presentation in patients with advanced cancer, occurring in up to 70% of patients. In 2008, it was estimated that almost 300,000 patients with advanced cancer in the USA had skeletal metastases. Skeletal metastases can dramatically decrease the quality of life as a result of skeletal related events. In 2006, the financial burden of treating patients with metastatic bone disease in the USA per year was estimated at being approximately 12.6 billion dollars, which accounted for 17% of the total annual cost of cancer treatments. Patients with metastatic bone disease may seek medical care at community hospitals. Traditional management techniques involve a combination of pharmacotherapy, radiotherapy, and surgical procedures. Over the last few decades, advances in medical and surgical treatments have been proposed regarding the management of metastatic bone disease. Considering the limited expectancy of most patients with bone metastases, the main goal of novel medical and less invasive 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.

We are pleased to invite the submission of manuscripts focusing on new research on basic, clinical, and surgical research on the treatment of bone metastases.

The Special Issue aims to explore all area of treatment of bone metastases, including the following:

  • Surveillance imaging and diagnostic work up to ensure the accurate and timely identification of bone metastases.
  • Current systemic treatment options with zolendronic acid and denosumab in order to provide knowledge of innovative techniques in evolving therapies.
  • The role of interventional radiology: embolization, electro-chemotherapy, magnetic resonance imaging guided high-intensity focused ultrasound, and thermal ablation therapies.
  • The search for possible prognostic factors affecting survival: the life expectancy of patients with bone metastases seems to be the most important factor in determining the surgical treatment, avoiding over- or under-treatments.
  • The role of surgery: based on the risk of surgical complications, the patient’s prognosis seems to be important regarding the type of surgical treatment in a patient with bone metastases.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: nuclear medicine, radiology, interventional radiology, orthopedics, and oncology.

We look forward to receiving your contributions.

Dr. Costantino Errani
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bone metastases
  • imaging
  • prognostic factors
  • prognostic score
  • novel therapies
  • medical treatments
  • interventional radiology
  • surgery

Published Papers (5 papers)

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Research

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Article
The Role of a Navigational Radiofrequency Ablation Device and Concurrent Vertebral Augmentation for Treatment of Difficult-to-Reach Spinal Metastases
Curr. Oncol. 2021, 28(5), 4004-4015; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol28050340 - 08 Oct 2021
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Abstract
Aims: The purpose of this study was to assess the effectiveness of a navigational radiofrequency ablation device with concurrent vertebral augmentation in the treatment of posterior vertebral body metastatic lesions, which are technically difficult to access. Primary outcomes of the study were evaluation [...] Read more.
Aims: The purpose of this study was to assess the effectiveness of a navigational radiofrequency ablation device with concurrent vertebral augmentation in the treatment of posterior vertebral body metastatic lesions, which are technically difficult to access. Primary outcomes of the study were evaluation of pain palliation and radiologic assessment of local tumor control. Materials and Methods: Thirty-five patients with 41 vertebral spinal metastases involving the posterior vertebral body underwent computed tomography-guided percutaneous targeted radiofrequency ablation, with a navigational radiofrequency ablation device, associated with vertebral augmentation. Twenty-one patients (60%) had 1 or 2 metastatic lesions (Group A) and fourteen (40%) patients had multiple (>2) vertebral lesions (Group B). Changes in pain severity were evaluated by visual analog scale (VAS). Metastatic lesions were evaluated in terms of radiological local control. Results: The procedure was technically successful in all the treated vertebrae. Among the symptomatic patients, the mean VAS score dropped from 5.7 (95% CI 4.9–6.5) before tRFA and to 0.9 (95% CI 0.4–1.3) after tRFA (p < 0.001). The mean decrease in VAS score between baseline and one week follow up was 4.8 (95% CI 4.2–5.4). VAS decrease over time between one week and one year following radiofrequency ablation was similar, suggesting that pain relief was immediate and durable. Neither patients with 1–2 vertebral metastases, nor those with multiple lesions, showed radiological signs of local progression or recurrence of the tumor in the index vertebrae during a median follow up of 19 months (4–46 months) and 10 months (4–37 months), respectively. Conclusion: Treatment of spinal metastases with a navigational radiofrequency ablation device and vertebral augmentation can be used to obtain local tumor control with immediate and durable pain relief, providing effective treatment in the multimodality management of difficult-to-reach spinal metastases. Full article
(This article belongs to the Special Issue Treatment of Bone Metastasis)
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Article
Impact of an Augmented Reality Navigation System (SIRIO) on Bone Percutaneous Procedures: A Comparative Analysis with Standard CT-Guided Technique
Curr. Oncol. 2021, 28(3), 1751-1760; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol28030163 - 08 May 2021
Cited by 1 | Viewed by 635
Abstract
(1) Background: The purpose of this study is to evaluate the impact of an augmented reality navigation system (SIRIO) for percutaneous biopsies and ablative treatments on bone lesions, compared to a standard CT-guided technique. (2) Methods: Bioptic and ablative procedures on bone lesions [...] Read more.
(1) Background: The purpose of this study is to evaluate the impact of an augmented reality navigation system (SIRIO) for percutaneous biopsies and ablative treatments on bone lesions, compared to a standard CT-guided technique. (2) Methods: Bioptic and ablative procedures on bone lesions were retrospectively analyzed. All procedures were divided into SIRIO and Non-SIRIO groups and in <2 cm and >2 cm groups. Number of CT-scans, procedural time and patient’s radiation dose were reported for each group. Diagnostic accuracy was obtained for bioptic procedures. (3) Results: One-hundred-ninety-three procedures were evaluated: 142 biopsies and 51 ablations. Seventy-four biopsy procedures were performed using SIRIO and 68 under standard CT-guidance; 27 ablative procedures were performed using SIRIO and 24 under standard CT-guidance. A statistically significant reduction in the number of CT-scans, procedural time and radiation dose was observed for percutaneous procedures performed using SIRIO, in both <2 cm and >2 cm groups. The greatest difference in all variables examined was found for procedures performed on lesions <2 cm. Higher diagnostic accuracy was found for all SIRIO-assisted biopsies. No major or minor complications occurred in any procedures. (4) Conclusions: The use of SIRIO significantly reduces the number of CT-scans, procedural time and patient’s radiation dose in CT-guided percutaneous bone procedures, particularly for lesions <2 cm. An improvement in diagnostic accuracy was also achieved in SIRIO-assisted biopsies. Full article
(This article belongs to the Special Issue Treatment of Bone Metastasis)
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Review

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Review
Current Overview of Treatment for Metastatic Bone Disease
Curr. Oncol. 2021, 28(5), 3347-3372; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol28050290 - 29 Aug 2021
Cited by 2 | Viewed by 734
Abstract
The number of patients with bone metastasis increases as medical management and surgery improve the overall survival of patients with cancer. Bone metastasis can cause skeletal complications, including bone pain, pathological fractures, spinal cord or nerve root compression, and hypercalcemia. Before initiation of [...] Read more.
The number of patients with bone metastasis increases as medical management and surgery improve the overall survival of patients with cancer. Bone metastasis can cause skeletal complications, including bone pain, pathological fractures, spinal cord or nerve root compression, and hypercalcemia. Before initiation of treatment for bone metastasis, it is important to exclude primary bone malignancy, which would require a completely different therapeutic approach. It is essential to select surgical methods considering the patient’s prognosis, quality of life, postoperative function, and risk of postoperative complications. Therefore, bone metastasis treatment requires a multidisciplinary team approach, including radiologists, oncologists, and orthopedic surgeons. Recently, many novel palliative treatment options have emerged for bone metastases, such as stereotactic body radiation therapy, radiopharmaceuticals, vertebroplasty, minimally invasive spine stabilization with percutaneous pedicle screws, acetabuloplasty, embolization, thermal ablation techniques, electrochemotherapy, and high-intensity focused ultrasound. These techniques are beneficial for patients who may not benefit from surgery or radiotherapy. Full article
(This article belongs to the Special Issue Treatment of Bone Metastasis)
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Other

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Commentary
The Surgical Management of Proximal Femoral Metastases: A Narrative Review
Curr. Oncol. 2021, 28(5), 3748-3757; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol28050320 - 28 Sep 2021
Viewed by 546
Abstract
The proximal femur is a common location for the development of bony metastatic disease. Metastatic bone disease in this location can cause debilitating pain, pathologic fractures, reduced quality of life, anemia or hypercalcemia. A thorough history, physical examination and preoperative investigations are required [...] Read more.
The proximal femur is a common location for the development of bony metastatic disease. Metastatic bone disease in this location can cause debilitating pain, pathologic fractures, reduced quality of life, anemia or hypercalcemia. A thorough history, physical examination and preoperative investigations are required to ensure accurate diagnosis and prognosis. The goals of surgical management is to provide pain relief and return to function with a construct that provides stability to allow for immediate weightbearing. Current surgical treatment options include intramedullary nailing, hemiarthroplasty or total hip arthroplasty and endoprosthetic reconstructions. Oligometastatic renal cell carcinoma must be given special consideration as tumor resection and reconstruction has survival benefit. Both tumor and patient characteristics must be taken into account before deciding on the appropriate surgical intervention. Full article
(This article belongs to the Special Issue Treatment of Bone Metastasis)
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Commentary
Emerging Concepts in the Surgical Management of Peri-Acetabular Metastatic Bone Disease
Curr. Oncol. 2021, 28(4), 2731-2740; https://0-doi-org.brum.beds.ac.uk/10.3390/curroncol28040238 - 17 Jul 2021
Cited by 1 | Viewed by 643
Abstract
The pelvis is a common site of metastatic bone disease. Peri-acetabular lesions are particularly challenging and can cause severe pain, disability and pathologic fractures. Surgical management of these lesions has historically consisted of cementoplasty for contained lesions and Harrington reconstructions for larger, more [...] Read more.
The pelvis is a common site of metastatic bone disease. Peri-acetabular lesions are particularly challenging and can cause severe pain, disability and pathologic fractures. Surgical management of these lesions has historically consisted of cementoplasty for contained lesions and Harrington reconstructions for larger, more destructive lesions. Due to the limitations of these procedures, a number of novel procedures have been developed to manage this challenging problem. Percutaneous techniques—including acetabular screw fixation and cementoplasty augmented with screws—have been developed to minimize surgical morbidity. Recent literature has demonstrated a reliable reduction in pain and improvement in function in appropriately selected patients. Several adjuncts to the Harrington procedure have been utilized in recent years to reduce complication rates. The use of constrained liners and dual mobility bearings have reduced the historically high dislocation rates. Cage constructs and porous tantalum implants are becoming increasingly common in the management of large bony defects and destructive lesions. With novel and evolving surgical techniques, surgeons are presented with a variety of surgical options to manage this challenging condition. Physicians must take into account the patients’ overall health status, oncologic prognosis and anatomic location and extent of disease when developing an appropriate surgical plan. Full article
(This article belongs to the Special Issue Treatment of Bone Metastasis)
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