Orthopedic management of metastatic disease
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| Sprache: | English |
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Philadelphia [u.a.]
Saunders
2000
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| Schriftenreihe: | The orthopedic clinics of North America
31,4 |
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| 245 | 1 | 0 | |a Orthopedic management of metastatic disease |c William G. Ward ... guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2000 | |
| 300 | |a XII S., S. 515 - 697 |b zahlr. Ill., graph. Darst. | ||
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| 650 | 4 | |a Bone metastasis |x Treatment | |
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Datensatz im Suchindex
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| adam_text | ORTHOPEDIC MANAGEMENT OF METASTATIC DISEASE
CONTENTS
Preface xi
William G. Ward and Terrance D. Peabody
Incidence, Location, and Diagnostic Evaluation of Metastatic
Bone Disease 515
William D. Hage, Albert J. Aboulafia, and David M. Aboulafia
Metastatic carcinoma is the most common malignancy of bone. Tin1 clinical
presentation of patients with skeletal metastasis is variable. When asked
to evaluate a patient with a pathologic lesion or unexplained bone pain,
the orthopedic surgeon should follow a logical sequence of steps in evalu¬
ating the patient with suspected metastasis to optimize care and avoid
complications. In the majority of cases, a systematic approach to the
patient with skeletal metastasis leads to the correct diagnosis.
The Mechanism of Metastasis 529
Allaaddin Mollabashy and Mark Scarborough
The establishment of clinically detectable skeletal metastasis is a multifac
torial process. This process can be divided into three general areas of
understanding. The first is that of the intrinsic characteristics and proper¬
ties of the tumor cells, which allow and facilitate their migration from the
site of primary neoplasia to the distant host skeleton. Secondly, there
are antatomic considerations of the human body, which influence the
distribution of metastatic seeding. Thirdly, there are the considerations of
the host organism s biology, including the immune system, the circulatory
system, and the affected host skeleton, which hinder and, nt times, potenti¬
ate the ability of neoplastic cells to establish skeletal lesions.
Pathology of Skeletal Metastases 537
John M. Salmon and Scott E. Kilpatrick
Metastatic disease involving the skeleton is an unfortunate and common
occurrence in cancer patients. Choosing the best diagnostic approach re¬
quires knowledge of the patient s clinical history, the radiologic appear¬
ance of the lesion, the differential diagnosis, and the ability of the diagnos
ORTHOPEDIC CLINICS OF NORTH AMERICA
VOLUME 30 • ~UMBER 4 • OCTOBER 2000 vii
tic modality to answer the questions that must be addressed. In difficult
cases, interaction between the pathologist and clinician before biopsy may
make the difference between a rapid procedure serving to definitively
diagnose and effectively stage a patient and a costly procedure that pro¬
vides little or no information.
Medical Management of Metastatic Skeletal Disease 545
Paul D. Savage and William G. Ward
Managing patients with metastatic skeletal disease requires attention to
organ systems not usually managed by orthopedic surgeons and nonsurgi
cal management of metastatic bone lesions. A coordinated care plan is
required for delivery of optimal care and follow up on lesions to ensure
that an appropriate response to therapeutic interventions occurs before the
onset of catastrophic fractures. This article reviews nonoperative measures,
including chemotherapy and pain management. Special attention is given
to bisphosphonate administration, a recent therapeutic addition that has
been shown to decrease the number and severity of skeletal events. Com¬
plications resulting from treatment are discussed and a review of current
management recommendations is provided.
Radiation Therapy 557
Deborah A. Frassica, Sarah Thurman, and James Welsh
Radiation therapy is commonly used to alleviate the pain associated with
bone metastases. This article reviews the components of the radiation
oncology evaluation. The options for use of ionizing radiation including
postoperative treatment, limited volume external beam radiotherapy,
wide field radiotherapy, and radioisotope therapy are compared and con¬
trasted. Side effects and toxidties of radiotherapy are discussed.
Indications for Operative Treatment 567
Bruce Rougraff
The importance of careful assessment of clinical, biomedical, and radio
graphic factors in the indications for operative treatment are stressed in
this article. The indication for surgical resection of solitary lesions versus
simple stabilization are compared and contrasted. The biologic behavior
of various types of tumors is emphasized.
Perioperative Considerations in Patients with Metastatic Bone
Disease 577
Christopher Bibbo, Dipak V. Patel, and Joseph Benevenia
Preoperative assessment of patients with metastatic bone disease includes
a history and physical examination, laboratory evaluation, and standard
radiographs. Perioperative diagnostics include technetium bone scan, CT
scans, MR imaging, positron emission tomography, and biopsy. The role
of preoperative tumor embolization and vena cava filter placement is
discussed in this article. Guidelines for pain control are provided. Surgical
planning and instrument considerations for long bone lesions, periarticular
lesions, and pelvis and acetabular lesions are addressed. The importance
of rehabilitation for patients with metastatic bone disease is emphasized.
Management of Metastatic Lesions of the Humerus 597
Christopher J. Bashore and H. Thomas Temple
The management of metastatic disease in the humerus requires consider¬
ation of many factors. An understanding of the disease process, attention
Viii CONTENTS
to the principles of biopsy, and careful evaluation of the patient s general
condition and location and degree of bone destruction are critical elements
in determining treatment. Treatment should be individualized and requires
a multidisciplinary approach to select a strategy that will alleviate pain
and optimize function.
Management of Metastatic Disease of the Spine 611
F. Todd Wetzel and Frank M. Phillips
Surgical management of metastatic disease of the spine may be indicated
in cases of dyphotic collapse and neurologic impairment. Metastatic dis¬
ease in this case is best accomplished from an anterior approach. In cases
with neurologic involvement alone or bony involvement without collapse,
adjuvant therapy (usually radiotherapy) may be effective.
Operative Management of Metastases to the Pelvis and
Acetabulum 623
Francis R. Patterson and Terrance D. Peabody
Metastatic carcinoma to the pelvis and acetabulum is a common and
challenging problem. The goals of treatment are to alleviate pain, prevent
pathologic fracture, and maintain or restore independent ambulation. Op¬
erative intervention ranges from conventional hip arthroplasty to complex
acetabular reconstruction that can be technically challenging. With proper
patient selection, appropriate component utilization and competent surgi¬
cal technique, good to excellent outcomes can be achieved.
Metastatic Disease of the Femur: Surgical Management 633
William G. Ward, Jeff Spang, and David Howe
Metastatic cancer involves the femur more often than any other long bone.
Since independent ambulation requires an intact femur, stabilization or
reconstruction of a femur weakened by cancer assumes tremendous impor¬
tance in maintaining an acceptable quality of life for the cancer patient.
This article reviews the surgical options and ideal indications for the
reconstruction of femoral metastatic disease.
Management of Metastatic Disease of Other Bones 647
Robert J. Esther and Gary D. Bos
Metastases to the scapula and distal sites on the upper and lower extremit¬
ies are infrequent. Although these metastases tend to occur in patients
with advanced disease, a distal metastasis is occasionally the sole meta¬
static location. Distal metastases do not pose an immediate threat to a
patient s life; however, they may cause significant pain and disability.
Appropriate management can considerably enhance function, quality of
life, and, occasionally, survival. Seven cases of distal metastasis are pre¬
sented in this article with discussion of operative and nonoperative ap¬
proaches to management.
Management of Metastatic Disease to Soft Tissue 661
Timothy A. Damron and John Heiner
Metastases to soft tissue are rare clinical problems. Most metastases are
caused by carcinomatous deposits in the skeletal muscle, with lung carci¬
noma being the most common primary cause. Pain is more commonly
observed in association with metastatic soft tissue masses than for soft
CONTENTS ix
tissue sarcomas. Treatment should be individualized, but for most carcino¬
mas, initial radiotherapy treatment is recommended. Prognosis varies with
the underlying disease, but for the typical patient with a metastatic carci¬
noma, mean survival duration is approximately 6 months.
Errors and Pitfalls in the Diagnosis and Treatment of Metastatic
Bone Disease 675
Christopher P. Beauchamp
Errors in the management of patients with bone and soft tissue neoplasms
have devastating effects on patient outcome. Many of the errors have
recurrent themes and are usually avoidable. By using a logical approach
to the management of metastatic disease, surgeons may avoid some of the
common pitfalls associated with treatment.
X CONTENTS
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| physical | XII S., S. 515 - 697 zahlr. Ill., graph. Darst. |
| publishDate | 2000 |
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| publisher | Saunders |
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| series | The orthopedic clinics of North America |
| series2 | The orthopedic clinics of North America |
| spelling | Orthopedic management of metastatic disease William G. Ward ... guest ed. Philadelphia [u.a.] Saunders 2000 XII S., S. 515 - 697 zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier The orthopedic clinics of North America 31,4 Bone metastasis Treatment Orthopedics Therapie (DE-588)4059798-2 gnd rswk-swf Knochenmetastase (DE-588)4164290-9 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Knochenmetastase (DE-588)4164290-9 s Therapie (DE-588)4059798-2 s DE-604 Ward, William G. Sonstige (DE-588)1067407456 oth The orthopedic clinics of North America 31,4 (DE-604)BV000001089 31,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009155226&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Orthopedic management of metastatic disease The orthopedic clinics of North America Bone metastasis Treatment Orthopedics Therapie (DE-588)4059798-2 gnd Knochenmetastase (DE-588)4164290-9 gnd |
| subject_GND | (DE-588)4059798-2 (DE-588)4164290-9 (DE-588)4143413-4 |
| title | Orthopedic management of metastatic disease |
| title_auth | Orthopedic management of metastatic disease |
| title_exact_search | Orthopedic management of metastatic disease |
| title_full | Orthopedic management of metastatic disease William G. Ward ... guest ed. |
| title_fullStr | Orthopedic management of metastatic disease William G. Ward ... guest ed. |
| title_full_unstemmed | Orthopedic management of metastatic disease William G. Ward ... guest ed. |
| title_short | Orthopedic management of metastatic disease |
| title_sort | orthopedic management of metastatic disease |
| topic | Bone metastasis Treatment Orthopedics Therapie (DE-588)4059798-2 gnd Knochenmetastase (DE-588)4164290-9 gnd |
| topic_facet | Bone metastasis Treatment Orthopedics Therapie Knochenmetastase Aufsatzsammlung |
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