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Cancers
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Surgical Treatment of Bone Metastases: 2nd Edition
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Surgical Treatment of Bone Metastases: 2nd Edition

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 29 August 2025 | Viewed by 2780

Special Issue Editor

Prof. Dr. Michael Mørk Petersen

E-Mail Website
Guest Editor
Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University of Copenhagen, 10. DK-1165 Copenhagen, Denmark
Interests: orthopedic oncology; bone sarcomas; soft tissue sarcomas; bone metastases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This is the second edition of the Special Issue “Surgical Treatment of Bone Metastases”, available at

https://www.mdpi.com/journal/cancers/special_issues/surgical_treatment_bone_metastases.

Bone metastases are common occurrences in many cancers and are especially common in lung, breast, kidney, and prostate cancer. Bone metastases can cause painful and debilitating bony lesions or pathological fractures, and when located in the spine, even spinal cord or nerve root damage leading to paralysis can occur. Surgical treatment of bone metastases is often a major surgery (e.g., spinal surgery or joint replacement surgery), with a poor performance status and a high mortality. However, this surgery is often advantageous for the patients with respect to pain relief and function, but it can only very seldom be considered curative. Therefore, the selection of the right patients and surgical technique for bone metastasis surgery are extremely important in this patient group.

The intention of this Special Issue is to highlight all aspects of bone metastasis surgery research performed on all types of cancer patients, including patients suffering from hematologic malignancies.

Potential topics of interest, among others, for this Special Issue are surgical technique and selection of implants, patient survival, prediction of survival, surgical complications, implant survival, functional results, quality of life, and health economics.

Prof. Dr. Michael Mørk Petersen
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 submissions that pass pre-check are 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 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. Cancers 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 2900 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

  • metastatic bone disease
  • bone metastasis
  • pathological fractures
  • surgical treatment
  • patients survival
  • implant survival
  • functional results
  • surgical technique

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Published Papers (2 papers)

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12 pages, 381 KiB  
Article
What Is the Survivorship of Megaprosthetic Reconstruction Following the Resection of Renal Cell Carcinoma Long Bone Metastases and What Are the Potential Risk Factors for a Prosthetic Complication?
by Sebastian Bockholt, Kristian Nikolaus Schneider, Georg Gosheger, Maria Anna Smolle, Niklas Deventer, Dimosthenis Andreou and Christoph Theil
Cancers 2025, 17(12), 1982; https://doi.org/10.3390/cancers17121982 - 13 Jun 2025
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Abstract
Background: Long bone metastases are common in patients with metastatic renal cell carcinoma (RCC). One potential surgical treatment option is resection and megaprosthetic reconstruction. However, implant complications and survival are poorly understood. This study analyzes patient and implant survival as well as associated [...] Read more.
Background: Long bone metastases are common in patients with metastatic renal cell carcinoma (RCC). One potential surgical treatment option is resection and megaprosthetic reconstruction. However, implant complications and survival are poorly understood. This study analyzes patient and implant survival as well as associated risk factors. Methods: This is a retrospective study from a single academic center, analyzing 86 patients that underwent resection and megaprosthetic reconstruction performed between 1993 and 2017. The most common location of megaprosthetic reconstruction was the proximal femur (PFR) in 38% (33 of 86) of patients. We calculated overall patient survival and associated risk factors using the Kaplan–Meier method and implant survivorship using a competing risk analysis. Results: A total of 73% (63/86) of patients died of their disease after a median of 19 (IQR 9–37) months following surgery, and a median of 71 (IQR 31–132) months after the initial diagnosis of RCC. The overall survival probability was 29% (95% CI 18–40%) five years after surgery. The five-year risk of revision surgery (within a competing risk framework) was 18% (95% CI 11–28). A total of 8% (7 of 86) of patients underwent an exchange of the implant itself. Patients with total bone replacements had a higher revision risk (SHR 19.46 (95% CI 6.9–54.9), p < 0.01). Furthermore, the revision risk was higher with increasing reconstruction length per mm (SHR 1.01 (95% CI 1.01–1.02), p = 0.03) and prolonged surgical time per minute (SHR: 1.01 (95% CI 1.0–1.02), p < 0.01). Local postoperative radiation treatment (RTX) was associated with an increased risk for revisions (SHR 2.59 (95% CI 0.96–6.95), p = 0.06). Conclusions: Modular megaprostheses demonstrated a fairly low risk of implant revision although postoperative radiation therapy and total bone replacements are associated with an increased risk. Full article
(This article belongs to the Special Issue Surgical Treatment of Bone Metastases: 2nd Edition)
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18 pages, 1999 KiB  
Systematic Review
Denosumab vs. Zoledronic Acid for Metastatic Bone Disease: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Benjamin G. Wajda, Leah E. Ferrie, Annalise G. Abbott, Golpira Elmi Assadzadeh, Michael J. Monument and Joseph K. Kendal
Cancers 2025, 17(3), 388; https://doi.org/10.3390/cancers17030388 - 24 Jan 2025
Viewed by 2327
Abstract
Background: Metastatic bone disease (MBD) presents significant challenges in patient management, leading to skeletal-related events (SREs), compromised health-related quality of life, and heightened pain experiences. Denosumab (Dmab) and zoledronic acid (ZA) are bone-modifying agents (BMAs) commonly employed to mitigate the sequelae of [...] Read more.
Background: Metastatic bone disease (MBD) presents significant challenges in patient management, leading to skeletal-related events (SREs), compromised health-related quality of life, and heightened pain experiences. Denosumab (Dmab) and zoledronic acid (ZA) are bone-modifying agents (BMAs) commonly employed to mitigate the sequelae of MBD. Previous meta-analyses have assessed primary outcomes such as overall survival, pathological fractures, radiation to bone, and the time to SREs within studies. However, a single comprehensive analysis comparing their efficacy across multiple primary and secondary outcomes, as well as cost-effectiveness in specific cancer types, has not yet been conducted. Methods: A literature search identified relevant randomized controlled trials (RCTs), and the primary outcomes included overall survival, pathologic fractures, radiation to bone, and the time to SREs within studies. Secondary outcomes included adverse events, pain, analgesia usage, quality of life, and cost. Results: Meta-analysis revealed that Dmab effectively reduced the need for bone-targeted radiation therapy and was superior to ZA in delaying the time to SREs, except in multiple myeloma. Dmab also reduced pathological fracture incidences in breast cancer patients by 39%. Conclusions: Our analysis suggests that while both agents similarly impact overall survival and disease progression, Dmab offers advantages in SRE reduction and improved HRQoL and pain outcomes with lower rates of opioid usage, albeit with higher risks of hypocalcemia and osteonecrosis in some subgroups. The consensus on cost-effectiveness is mixed and varies based on the cancer type and healthcare system, with some studies favoring Dmab’s superior efficacy and safety, while others find ZA more cost-effective due to its lower cost. This study underscores the potential of Dmab as a preferred BMA for MBD management, especially for high-risk skeletal complications, while highlighting cancer-specific safety considerations. Further research is warranted to refine cancer-specific BMA use and optimize MBD management strategies. Full article
(This article belongs to the Special Issue Surgical Treatment of Bone Metastases: 2nd Edition)
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