A Tailored Approach for Appendicular Impending and Pathologic Fractures in Solid Cancer Metastases
by
, , and
Joaquim Soares do Brito
1,*, 
Raquel Lopes-Brás
2,
André Abrunhosa-Branquinho
3,
Isabel Fernandes
2,
Inês Gomes
4,
Sandra Casimiro
4
and
Luís Costa
2,4,* 1
Department of Orthopedics, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisbon, Portugal
2
Department of Medical Oncology, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisbon, Portugal
3
Department of Radiotherapy, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisbon, Portugal
4
Luis Costa Laboratory, Instituto de Medicina Molecular—João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisbon, Portugal
*
Authors to whom correspondence should be addressed.
Cancers 2022, 14(4), 893; https://doi.org/10.3390/cancers14040893
Submission received: 6 January 2022
/
Revised: 5 February 2022
/
Accepted: 10 February 2022
/
Published: 11 February 2022
(This article belongs to the Special Issue Invasion and Progression of Solid Tumors in Bone)
Simple Summary
Patients with bone metastases often suffer with complications, such as bone fractures, which have a substantial negative impact on clinical outcomes. To optimize clinical results, a tailored approach should be defined for managing impending or pathologic fractures in each individual case. The ability to control systemic disease, the extent, location and nature of bone metastases, and the biology of the underlying tumor, are the main factors that will define the strategy to follow.
Abstract
Advances in medical and surgical treatment have played a major role in increasing the survival rates of cancer patients with metastatic bone disease. The clinical course of patients with bone metastases is often impaired by bone complications, such as bone fractures, which have a substantial negative impact on clinical outcomes. To optimize clinical results and prevent a detrimental impact on patients’ health, a tailored approach should be defined for any given patient. The optimal management of impending or pathologic fractures is unknown and relies on a multidisciplinary approach to tailor clinical decisions to each individual patient. The ability to control systemic disease, the extent, location and nature of bone metastases, and the biology of the underlying tumor, are the main factors that will define the strategy to follow. The present review covers the most recent data regarding impending and pathologic fractures in patients with bone metastases, and discusses the medical and surgical management of patients presenting with metastatic bone disease in different clinical settings.
