Metastatic bone disease: current concepts of clinicopathophysiology and modern surgical treatment.

F. H. Sim, F. J. Frassica, Deborah Frassica

Research output: Contribution to journalArticle

Abstract

Metastases to bone are a common problem confronting both the orthopaedic oncologist and cancer specialists. Early diagnosis requires a knowledge of the pathogenesis of bone metastases. A primary route of metastatic cells is via Batson's vertebral vein plexus. An understanding of the pathophysiology enables the surgeon to plan effective treatment. As many patients continue to survive for prolonged periods following the detection of bone metastases, it is important to plan treatment that is durable and functional. Non-operative treatment is utilised for small lesions (less than 25 percent of the cortical diameter). Radiotherapy (generally 3000 cGy in ten fractions), patient education (to avoid excessive torsional loads), and systemic chemotherapy or hormonal therapy are the mainstays of non-operative treatment. The indications for surgical treatment include: (1) lesions greater than 50 percent the diameter of the cortex, (2) permeative lesions in high stress areas (subtrochanteric region of the hip, mid-femoral diaphysis, mid humeral metaphysis), and (3) lesions in which pain persists following external beam irradiation. Early and effective treatment improves the remaining quality of life in patients with metastatic bone disease. A knowledge of the pathogenesis and pathophysiology aids the clinician in making an early diagnosis.

Original languageEnglish (US)
Pages (from-to)274-279
Number of pages6
JournalAnnals of the Academy of Medicine Singapore
Volume21
Issue number2
StatePublished - Mar 1992
Externally publishedYes

Fingerprint

Bone Diseases
Neoplasm Metastasis
Bone and Bones
Therapeutics
Early Diagnosis
Diaphyses
Patient Education
Thigh
Orthopedics
Hip
Veins
Radiotherapy
Quality of Life
Drug Therapy
Pain
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Metastatic bone disease : current concepts of clinicopathophysiology and modern surgical treatment. / Sim, F. H.; Frassica, F. J.; Frassica, Deborah.

In: Annals of the Academy of Medicine Singapore, Vol. 21, No. 2, 03.1992, p. 274-279.

Research output: Contribution to journalArticle

@article{09f32e7eb2b24c619625372ab7e87173,
title = "Metastatic bone disease: current concepts of clinicopathophysiology and modern surgical treatment.",
abstract = "Metastases to bone are a common problem confronting both the orthopaedic oncologist and cancer specialists. Early diagnosis requires a knowledge of the pathogenesis of bone metastases. A primary route of metastatic cells is via Batson's vertebral vein plexus. An understanding of the pathophysiology enables the surgeon to plan effective treatment. As many patients continue to survive for prolonged periods following the detection of bone metastases, it is important to plan treatment that is durable and functional. Non-operative treatment is utilised for small lesions (less than 25 percent of the cortical diameter). Radiotherapy (generally 3000 cGy in ten fractions), patient education (to avoid excessive torsional loads), and systemic chemotherapy or hormonal therapy are the mainstays of non-operative treatment. The indications for surgical treatment include: (1) lesions greater than 50 percent the diameter of the cortex, (2) permeative lesions in high stress areas (subtrochanteric region of the hip, mid-femoral diaphysis, mid humeral metaphysis), and (3) lesions in which pain persists following external beam irradiation. Early and effective treatment improves the remaining quality of life in patients with metastatic bone disease. A knowledge of the pathogenesis and pathophysiology aids the clinician in making an early diagnosis.",
author = "Sim, {F. H.} and Frassica, {F. J.} and Deborah Frassica",
year = "1992",
month = "3",
language = "English (US)",
volume = "21",
pages = "274--279",
journal = "Annals of the Academy of Medicine, Singapore",
issn = "0304-4602",
publisher = "Academy of Medicine Singapore",
number = "2",

}

TY - JOUR

T1 - Metastatic bone disease

T2 - current concepts of clinicopathophysiology and modern surgical treatment.

AU - Sim, F. H.

AU - Frassica, F. J.

AU - Frassica, Deborah

PY - 1992/3

Y1 - 1992/3

N2 - Metastases to bone are a common problem confronting both the orthopaedic oncologist and cancer specialists. Early diagnosis requires a knowledge of the pathogenesis of bone metastases. A primary route of metastatic cells is via Batson's vertebral vein plexus. An understanding of the pathophysiology enables the surgeon to plan effective treatment. As many patients continue to survive for prolonged periods following the detection of bone metastases, it is important to plan treatment that is durable and functional. Non-operative treatment is utilised for small lesions (less than 25 percent of the cortical diameter). Radiotherapy (generally 3000 cGy in ten fractions), patient education (to avoid excessive torsional loads), and systemic chemotherapy or hormonal therapy are the mainstays of non-operative treatment. The indications for surgical treatment include: (1) lesions greater than 50 percent the diameter of the cortex, (2) permeative lesions in high stress areas (subtrochanteric region of the hip, mid-femoral diaphysis, mid humeral metaphysis), and (3) lesions in which pain persists following external beam irradiation. Early and effective treatment improves the remaining quality of life in patients with metastatic bone disease. A knowledge of the pathogenesis and pathophysiology aids the clinician in making an early diagnosis.

AB - Metastases to bone are a common problem confronting both the orthopaedic oncologist and cancer specialists. Early diagnosis requires a knowledge of the pathogenesis of bone metastases. A primary route of metastatic cells is via Batson's vertebral vein plexus. An understanding of the pathophysiology enables the surgeon to plan effective treatment. As many patients continue to survive for prolonged periods following the detection of bone metastases, it is important to plan treatment that is durable and functional. Non-operative treatment is utilised for small lesions (less than 25 percent of the cortical diameter). Radiotherapy (generally 3000 cGy in ten fractions), patient education (to avoid excessive torsional loads), and systemic chemotherapy or hormonal therapy are the mainstays of non-operative treatment. The indications for surgical treatment include: (1) lesions greater than 50 percent the diameter of the cortex, (2) permeative lesions in high stress areas (subtrochanteric region of the hip, mid-femoral diaphysis, mid humeral metaphysis), and (3) lesions in which pain persists following external beam irradiation. Early and effective treatment improves the remaining quality of life in patients with metastatic bone disease. A knowledge of the pathogenesis and pathophysiology aids the clinician in making an early diagnosis.

UR - http://www.scopus.com/inward/record.url?scp=0026825722&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026825722&partnerID=8YFLogxK

M3 - Article

C2 - 1519902

AN - SCOPUS:0026825722

VL - 21

SP - 274

EP - 279

JO - Annals of the Academy of Medicine, Singapore

JF - Annals of the Academy of Medicine, Singapore

SN - 0304-4602

IS - 2

ER -