Metastatic Bone Disease - An Integrated Approach to Patient Care (May 27, 2024)_(3031520009)_(Springer).rar

Skeletally related events make up approximately 20% of the cancer care economy. Advances in understanding the pathobiology and better biotargeted therapy and improved surgical technology are occurring continuously. Hundreds of thousands of patients are living longer with ever-increasing tumor burden, but patients can remain siloed in their care as they navigate across subspecialty treatments. This comprehensive text ties it all together around the patient, integrating all aspects of care. Providing an integrated approach to the diagnosis and management of patients with metastatic bone disease (MBD), this revised and expanded text combines discussion of the pathobiology of the disease with the latest oncological and orthopedic treatment modalities. After opening with an examination of the epidemiology and impact of MBD, the biology of bone metastases are discussed, along with considerations of the tissue of origin, evaluation, biopsy andmedical therapy, including metabolic agents and biotargeting. The heart of the book presents oncological approaches (supportive, radiation and interventional) and principles of orthopedic surgical oncology, with subsequent chapters covering specific anatomy, from the pelvis to the lower extremity and the spine. Chapters on emerging surgical technology and future directions conclude the text. New to this edition are considerations around patient-reported outcomes. Utilizing the latest clinical evidence and treatment techniques, Metastatic Bone Disease, Second Edition is standalone resource reflecting a comprehensive, patient-centric resource for all types of providers. Preface/Acknowledgments to the Second Edition Preface/Acknowledgments: A Better Place Contents Part I: The Problem 1: Bone Metastases: Epidemiology and Societal Effect Introduction Epidemiology of Metastatic Bone Disease Incidence of Bone Metastases Site of Bone Metastases Incidence of Skeletal-Related Complications Cancer Survival Implications of Increasing Survival Incidence of Pathological Fractures Predicting Pathological Fracture Impact on Survival of Pathological Fractures Quality of Life and Bone Metastases The Economic and Social Burden of Skeletal Related Events in Metastatic Bone Disease Summary References Part II: Biology of Metastases and Tissue of Origin Considerations 2: Mechanisms Underlying Osteolytic and Osteoblastic Bone Metastases The Bone as a Favorable Premetastatic Niche for Cancer Bone Remodeling Osteoblasts Osteoclasts Calcium Homeostasis Tumor Contribution to Pre-metastatic Niche in Bone Metastatic Homing Bone Colonization Tumor Dormancy Osteolytic and Osteoblastic Metastases Osteolytic Metastases: Breast Cancer as the Prototype Osteoblastic Metastases: Prostate Cancer as the Prototype Bone Metastasis Therapies Conclusions References 3: Tissue Engineered Models to Study Bone Metastasis and Metastatic Bone Disease Introduction Introduction to Tissue-Engineered Models Two-Dimensional (Monolayer) Culture Models 3D Culture Models Scaffold Composition to Model the Bone Microenvironment Fiber Alignment Within Engineered Materials to Guide Cell Fate Substrate Mechanical Properties Influence Cancer Cell Behavior Spheroids as 3D Cell Culture Models of Cancer Organ-On-a-Chip Models of Tumor Metastasis Preclinical Models of Metastatic Bone Disease Future Outlook References 4: Biology of Bone Cancer Pain Introduction Biology of Cancer Pain Targeting Bone Cancer Pain Growth Factors Cytokines Ion Channels Osteoclast Conclusion References 5: Breast Cancer Bone Metastases Case Presentation Background Breast Cancer Characterization Staging Clinical Presentation of Breast Cancer Bony Metastasis Clinical Course Imaging in Breast Cancer Bone Metastases Treatment of Breast Cancer Bone Metastases Systemic Therapy Hormone Receptor Positive Metastatic Breast Cancer HER2-Positive Metastatic Breast Cancer Triple-Negative Metastatic Breast Cancer Osteoclast Inhibitors Local Therapy Analgesics Future Directions Case Follow-Up Summary References 6: Prostate Cancer Bone Metastases Introduction Biological Aspects Particular to Prostate Bone Metastasis Radiographic Appearance Histology Epidemiology and Prognosis Clinical Detection of Bone Metastasis Local Therapy Surgery Radiation Systemic Therapy Androgen Deprivation Therapy Chemotherapy Radioisotopes Immunotherapies PARP Inhibitors Adjunctive Therapy Osteoclast Inhibitors Conclusion References 7: Metastatic Primary Lung Cancer Introduction Work-Up Management of Disseminated Metastatic Disease Management of Limited Metastatic Disease Oligometastatic NSCLC to the Bone Conclusion References 8: Metastatic Bone Disease in Kidney Cancer Introduction Historical Overview of Management of Kidney Cancer Classification and Staging Treatment of RCC Treatment of Localized RCC Treatment of Advanced/Metastatic RCC Rationale for Cytoreductive Nephrectomy in mRCC Rationale for Metastasis-Directed Therapy in RCC Special Considerations for Bone Metastases in RCC Diagnosis of Bone Metastases Bone Metastases as a Prognostic Outcome Treatment of RCC Bone Metastases Surgery Radiation Therapy Bisphosphonates and RANK Ligand Inhibitors Systemic Therapy Summary References 9: Thyroid Cancer Bone Metastasis Introduction Epidemiology of Thyroid Cancer Risk Factors Classification Distant Metastasis Distant Metastasis and Primary Tumor Characteristics Diagnosis of Bone Metastasis X-Ray Imaging Computed Tomography (CT) and Magnetic Resonance Imaging Iodine-131 (I-131) Whole-Body Scan 18FDG-PET Scanning Treatment of Bone Metastasis RAI and TSH Suppression Bisphosphonate and Denosumab Therapy Kinase Inhibitors Surgery Radiotherapy Percutaneous/Adjunctive Procedures Conclusion References 10: Introduction to Multiple Myeloma and Multiple Myeloma Bone Disease Epidemiology of Multiple Myeloma Spectrum of Plasma Cell Diseases Risk Stratification and Staging of Multiple Myeloma Frontline Systemic Therapy for MM Induction Therapy for Newly Diagnosed MM The Role of Autologous Stem Cell Transplant in NDMM Induction Therapy for Newly Diagnosed Transplant-Ineligible MM Consolidation and Maintenance Therapy in MM Treatment of Relapsed Disease Bone Disease in Multiple Myeloma Pathogenesis of Bone Disease in MM Treatment of Bone Disease in MM References Part III: Work-Up for Patients with Suspected Metastatic Bone Disease 11: Evaluation of the Patient with Carcinoma of Unknown Origin Metastatic to Bone Introduction Discussion References 12: Biopsy Considerations Introduction Indications for Biopsy Procedural Techniques Biopsy Methods Incisional Biopsy Core Needle Biopsy Fine-Needle Aspiration Specimen Handling Summary References Part IV: Medical Therapy 13: Bisphosphonates, Denosumab, and Anabolic Agents in the Treatment of Metastatic Bone Disease References 14: Biotargeting in Metastatic Bone Disease Biotargeting in Breast Cancer Biotargeting in Prostate Cancer Biotargeting in Thyroid Cancer Biotargeting in Lung Cancer Biotargeting in Renal Cancer Biotargeting in Multiple Myeloma Biotargeting in Lymphoma References Part V: Supportive Oncology 15: Psychosocial Considerations for Patients with Metastatic Bone Disease Physical Psychosocial Screening, Assessment and Treatment Depression and Anxiety Post-Traumatic Stress Disorder Suicide Ideation Substance Abuse Psychiatry Spirituality and Religion Diversity Integrated and Complementary Medicine End-of-Life Care Planning and Decision-Making Conclusion References 16: Pain Management in Metastatic Bone Disease Introduction Clinical Presentation Medical Treatment Nonsteroidal Anti-Inflammatory Drugs Corticosteroids Full Agonist Opioids Partial Agonist Opioids Bisphosphonates and Denosumab Tricyclic Antidepressants Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) Ketamine Therapy Radiation Therapy Interventional Pain Medicine and Bone Pain OsteoCool High-Frequency Ultrasound Intrathecal Therapy Electrochemotherapy Vertebral Augmentation and Stabilization Conclusion(s) References 17: When Is Hospice Appropriate? The Role for Hospice in Palliating Patients with Bone Metastases The Imperative of Palliative Care in Metastatic Bone Disease The Evolution of Hospice and Palliative Care Introduction Case Study Case Commentary Opportunities for Palliative Care Integration Conclusion References 18: PROs Introduction Outcome Measurement Terms and Definitions Psychometrics Definitions Health Status Vs. Health: Related Quality-of-Life Measure Legacy, Disease-Specific, Location-Specific Vs. Generic Measures Orthopedic Oncology-Specific Patient-Reported Outcome Measures Musculoskeletal Tumor Society (MSTS) Scoring System Toronto Extremity Salvage Score (TESS) Bone Metastasis Quality of Life (BOMET-QoL) Generic Patient-Reported Outcome Measures Short-Form 36 (SF-36) Patient-Reported Outcome Measurement Information System (PROMIS®) Patient-Reported Preference Measures (PRPMs) References Part VI: Radiation Oncology 19: Current and Emerging Modalities Radiotherapy History Basic Radiobiology and Physics Radiotherapy for Bone Metastases Indications Mechanism of Pain Relief with RT Preparation for Treatment Delivery Radiotherapy for Spinal Cord Compression Conventional Radiation Therapy for Bone Metastases Single Versus Multiple Fractions Intensity Modulated Radiation Therapy (IMRT) Stereotactic Body Radiation Therapy (SBRT) Treatment by Histology Timing of Surgery and Radiotherapy Re-Irradiation Oligometastatic and Oligoprogressive Bony Metastatic Disease Conclusions References Part VII: Interventional Oncology 20: Ablation and Cementation Technologies Introduction Vertebral Augmentation Technical Aspects of VA Percutaneous Ablation Cryoablation Microwave Radiofrequency Thermal Protection Pelvic/Sacrum Stabilization References Part VIII: Principles of Orthopedic Surgical Oncology 21: Issues Facing the Established Metastatic Bone Disease Patient: Timing/Indications for Surgery Introduction Perioperative Risk Assessment of the Metastatic Bone Disease Patient Survival Estimation: Useful Guidance or Exercise in Futility? Timing: All Surgeries Are Not Created Equal Coordination with Chemotherapy and Radiation Tissue Sampling: More Than Just Diagnosis in the Age of Targeted Therapy Beyond Palliation: Surgery as a Means of Cancer Therapy References 22: Questions to Ask Your Medical Oncology Colleagues Introduction The Patient Life Expectancy What Is the Patient’s Life Expectancy? Medical “Fitness” Can This Patient Tolerate This Surgery? Perioperative Concerns Are There Specific Perioperative Concerns Our Team Should Know About? Expectations Do You Have a Sense for the Overall Expectations and Goals of the Patient and Family? The Disease Efficacy of Medical Therapy Can Medical Therapy Prevent or Augment This Surgical Procedure? Availability of Clinical Trial Does Surgery Affect Availability of Clinical Trials? Tissue Do You Need Tissue to Better Understand This Patient’s Disease? The Medications Wound Healing Is This Patient on Cytotoxic Therapy? Bisphosphonates or Rank-L Inhibitors Is This Patient on an Anti-Bone Resorption Medication? Logistics Timing of Surgery What Is the Schedule of Medical Therapy and Where Does Surgery Best Fit In? Perioperative Medical Care Who Will Be the On-Call Person for Oncologic Questions for This Patient? Follow-Up How Often Do You See This Patient? Conclusions References 23: Consideration of the Temporal Relationship Between Surgery and Radiation Therapy Introduction The Biology of Wound Healing Inflammatory Phase Proliferative Phase Maturation Phase Effects of Radiation Therapy on Wound Healing Summary References 24: Role of Surgery in Oligometastatic Disease Introduction Definitions and Historical Background Basic Science and Clinical Rationale Epidemiology of Bone Oligometastases Indications for Oncologic Surgery for Oligometastases Surgical Technique Resection Extended Curettage Results of Treatment SABR for Oligometastatic Bone Disease Percutaneous Ablation for Oligometastases Conclusions References Part IX: Specific Anatomic Considerations for Surgery 25: Metastatic Bone Disease: Pelvis Introduction Indications and Contraindications Preoperative Imaging and Surgical Planning Anatomic Considerations Exposure Curettage, Cementation, and Adjuvant Therapy Type I Lesions Type II Lesions Type III Lesions Type IV Lesions Soft Tissue Reconstruction and Wound Closure Postoperative Care Complications and Outcomes Conclusion References 26: Metastatic Bone Disease: Femur Introduction Presentation Nonoperative Treatment Operative Treatment Fixation Failure Minimally Invasive Procedures Intramedullary Nails Open Reduction and Internal Fixation Arthroplasty and Endoprosthetic Reconstruction Conclusion References 27: Metastatic Bone Disease: Femur and Tibia Introduction Evaluation of a Metastatic Bone Lesion of the Tibia Nonoperative Treatment of Metastatic Disease to the Tibia Treatment Algorithm for Operative Treatment Metastatic Disease to the Tibia Pathologic Fractures of the Tibia Conclusion References 28: Metastatic Bone Disease: Foot Introduction General Considerations Anatomic Locations Hindfoot Midfoot Forefoot Amputation Summary References 29: Metastatic Bone Disease: Humerus and Scapula Humeral Metastases Burden of Disease Nonoperative Care Operative Management Intramedullary Nail Fixation Plate Fixation Endoprosthetic Reconstructions Scapular Metastases Burden of Disease Nonoperative Care Operative Care Forequarter Amputation and Scapulectomy Scapulectomy Debulking, Cementoplasty, and Radiofrequency Ablation Summary References 30: Metastatic Bone Disease: Forearm and Hand Surgical Management in the Forearm Surgical Management in the Carpus and Hand Radiation Therapy for Distal Upper Extremity Metastasis Alternative Therapeutic Modalities References 31: Metastatic Bone Disease: Spine Introduction Background and Incidence Anatomic Considerations Prognosis Presentation and Diagnosis Imaging Biopsy Metastatic Epidural Spinal Cord Compression Treatment Overview Systemic Medical Treatment Radiotherapy Percutaneous Interventions Minimally Invasive Open Surgical Therapy Open Surgical Intervention Overview Margin of Tumor Resection Occipital-Cervical Junction Subaxial Cervical Spine and Cervicothoracic Junction Thoracic Spine Lumbar Spine Sacrum Current Technology Computer Navigation Radiolucent Implants Summary References Part X: Emergent Surgical Technologies 32: Intraoperative Imaging and Navigation Introduction Role of Navigation in Orthopedic Oncology Tumor Resection in Difficult Areas Minimally Invasive Treatment of Tumors Not Requiring Resection Alternative Resection Capabilities Periarticular Resection Reconstruction Robotics Pitfalls and Barriers to Development Conclusion References Part XI: Putting It All Together 33: Integrative Approach with the Patient in Mind: A Glance Forward References Index