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Current Oncology
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2nd Edition: Treatment of Bone Metastasis
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2nd Edition: Treatment of Bone Metastasis

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Bone and Soft Tissue Oncology".

Deadline for manuscript submissions: 15 July 2025 | Viewed by 6064

Special Issue Editor

Dr. Costantino Errani

E-Mail Website
Guest Editor
III Clinica di Ortopedia e Traumatologia, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
Interests: bone tumors; soft tissue tumors; bone sarcomas; soft tissue sarcomas; bone metastases; limb salvage surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This collection is the second edition of a previous Special Issue, entitled "Treatment of Bone Metastasis”(https://www.mdpi.com/journal/curroncol/special_issues/Treatment_Bone_Metastasis).

The incidence of metastatic bone disease is increasing, as patients with cancer are living longer. Bone is the third most common site of metastatic disease, after the lungs and the liver. Long bone metastases are a common presentation in patients with advanced cancer, occurring in up to 70% of patients. In 2008, it was estimated that almost 300,000 patients with advanced cancer in the USA had skeletal metastases. Skeletal metastases can dramatically decrease patients’ quality of life as a result of skeletal related events. In 2006, the financial burden of treating patients with metastatic bone disease in the USA per year was estimated to be approximately 12.6 billion dollars, which accounted for 17% of the total annual cost of cancer treatments. Patients with metastatic bone disease may seek medical care at community hospitals. Traditional management techniques involve a combination of pharmacotherapy, radiotherapy, and surgical procedures. Over the last few decades, advances in medical and surgical treatments have been proposed regarding the management of metastatic bone disease. Considering the limited expectancy of most patients with bone metastases, the main goal of novel medical and less invasive treatments is to improve the quality of life of patients with bone metastases, reducing the adverse effects related to the traditional medical or surgical treatments.

We are pleased to invite the submission of manuscripts focusing on new research on basic, clinical, and surgical research on the treatment of bone metastases.

This Special Issue aims to explore all areas of treatment of bone metastases, including the following:

  • Surveillance imaging and diagnostic work to ensure the accurate and timely identification of bone metastases.
  • Current systemic treatment options with zolendronic acid and denosumab in order to provide knowledge of innovative techniques in evolving therapies.
  • The role of interventional radiology: embolization, electro-chemotherapy, magnetic resonance imaging guided high-intensity focused ultrasound, and thermal ablation therapies.
  • The search for possible prognostic factors affecting survival—the life expectancy of patients with bone metastases seems to be the most important factor in determining the surgical treatment, and in avoiding over- or under-treatments.
  • The role of surgery: based on the risk of surgical complications, the patient’s prognosis seems to be important regarding the type of surgical treatment in a patient with bone metastases.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: nuclear medicine, radiology, interventional radiology, orthopedics, and oncology.

We look forward to receiving your contributions.

Dr. Costantino Errani
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 short 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. Current Oncology is an international peer-reviewed open access monthly 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 2200 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

  • bone metastases
  • imaging
  • prognostic factors
  • prognostic score
  • novel therapies
  • medical treatments
  • interventional radiology
  • surgery

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Published Papers (5 papers)

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13 pages, 4644 KiB  
Article
Impact of Bone-Modifying Agents on Post-Bone Metastasis Survival Across Cancer Types
by Hironari Tamiya, Kazumi Nishino, Yuji Kato, Reina Nakahashi-Kato, Yurika Kosuga-Tsujimoto, Shota Kinoshita, Rie Suzuki, Makiyo Watanabe, Toru Wakamatsu, Shigeki Kakunaga and Satoshi Takenaka
Curr. Oncol. 2025, 32(1), 42; https://doi.org/10.3390/curroncol32010042 - 15 Jan 2025
Viewed by 656
Abstract
Background: Bone metastasis is associated with a poor prognosis. Bone-modifying agents (BMA) are commonly used for the prevention or treatment of skeletal-related events (SRE) in patients with bone metastasis; however, whether or not treatment with BMA improves survival remains unclear. In this study, [...] Read more.
Background: Bone metastasis is associated with a poor prognosis. Bone-modifying agents (BMA) are commonly used for the prevention or treatment of skeletal-related events (SRE) in patients with bone metastasis; however, whether or not treatment with BMA improves survival remains unclear. In this study, we investigated whether BMA was involved in post-bone metastasis survival. Methods: A total of 539 cancer patients were retrospectively analyzed to identify significant independent factors in post-bone metastasis survival. Results: Among the overall population, patients with the following cancers had a median survival longer than 24 months: thyroid, 97.2 months; breast, 51.5 months; prostate, 47.2 months; and kidney, 38.8 months. In contrast, median post-bone metastasis survival was significantly shorter in gastrointestinal (GI) (6.5 months), head and neck (6.3 months), and urinary tract (3.4 months) cancers. In non-small cell lung cancer (NSCLC), the log-rank test demonstrated that the epidermal growth factor receptor (EGFR) mutation was a significant factor for post-bone metastasis survival: EGFR mutation (−) n = 67, median post-bone metastasis survival 11.5 months (95% CI: 6.0–15.2); EGFR mutation (+) n = 39, median post-bone metastasis survival 28.8 months (95% CI: 18.1–35.7) (p < 0.05). Intriguingly, treatment with BMA was a significant positive prognostic factor: BMA (−) n = 203, median post-bone metastasis survival 7.8 months (95% CI: 5.8–12.5); BMA (+) n = 336, median post-bone metastasis survival 21.9 months (95% CI: 16.1–26.4) (p < 0.001). Moreover, the Cox proportional hazards model showed that this was particularly evident in cancer types with poor prognosis such as GI cancer (hazard ratio [HR]: 0.62, 95% CI: 0.40–0.95; p < 0.05) and NSCLC without the epidermal growth factor receptor (EGFR) mutation (HR: 0.56, 95% CI: 0.34–0.91; p < 0.05). Conclusions: Treatment with BMA is recommended not only for the prevention and/or treatment of SRE, but also may have a positive impact on post-bone metastasis survival, particularly in cancers with typically poor post-bone metastasis survival such as GI cancer and NSCLC without the EGFR mutation. Full article
(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)
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8 pages, 484 KiB  
Communication
High Fracture Risk of Femoral Bone Metastasis Treated with Palliative Radiotherapy in Recent Years
by Kenji Makita, Hidehiro Hojo, Hidekazu Oyoshi, Takeshi Fujisawa, Masaki Nakamura, Gyo Uchida, Yume Koike, Yuzheng Zhou, Kento Tomizawa, Keiko Fukushi and Sadamoto Zenda
Curr. Oncol. 2024, 31(12), 7437-7444; https://doi.org/10.3390/curroncol31120549 - 22 Nov 2024
Viewed by 824
Abstract
Bone-modifying agents (BMAs) have been widely used to reduce skeletal-related events, including pathological fractures. Herein, we aimed to clarify the incidence of pathological fractures caused by high-risk femoral bone metastases after palliative radiotherapy (RT) in the BMA era and evaluate the necessity of [...] Read more.
Bone-modifying agents (BMAs) have been widely used to reduce skeletal-related events, including pathological fractures. Herein, we aimed to clarify the incidence of pathological fractures caused by high-risk femoral bone metastases after palliative radiotherapy (RT) in the BMA era and evaluate the necessity of prophylactic surgical stabilization. We assessed 90 patients with high-risk femoral bone metastases, indicated by Mirels’ scores ≥ 8, without pathological fractures and surgical fixations, who received palliative RT at our institution between January 2009 and December 2018. Pathological fracture incidence was analyzed using the Kaplan–Meier method and was 22.8% and 31.0% at 2 and 6 months, respectively. Pathological fractures were caused by 17 of 65 lesions (26.2%) and 9 of 25 lesions (36.0%) in patients who received BMAs and those who did not, respectively (p = 0.44). Additionally, 17 of 42 lesions (40.5%) and 9 of 48 lesions (18.8%) with axial cortical involvement ≥30 and <30 mm, respectively, caused pathological fractures (p = 0.02). The incidence of pathological fractures was high among patients with high-risk femoral bone metastases treated with palliative RT, particularly those with axial cortical involvement ≥30 mm. Therefore, aggressive indications for prophylactic surgical stabilization are warranted for high-risk femoral metastases despite BMA administration. Full article
(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)
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7 pages, 773 KiB  
Communication
Outcomes of Abductor Repair Using Mesh Augmentation in Oncologic Proximal Femur Replacement
by Samuel E. Broida, Harold I. Salmons, Aaron R. Owen and Matthew T. Houdek
Curr. Oncol. 2024, 31(10), 5730-5736; https://doi.org/10.3390/curroncol31100425 - 24 Sep 2024
Viewed by 872
Abstract
Reconstruction of the abductor mechanism remains a primary challenge with contemporary proximal femoral replacement (PFR) surgery. Previously, techniques such as trochanteric preservation or direct repair to the implant have been described; however, these strategies are limited in their ability to tension the repair [...] Read more.
Reconstruction of the abductor mechanism remains a primary challenge with contemporary proximal femoral replacement (PFR) surgery. Previously, techniques such as trochanteric preservation or direct repair to the implant have been described; however, these strategies are limited in their ability to tension the repair and reattach other muscles of the hip girdle. The aim of this study was to evaluate the outcomes of patients undergoing oncologic PFR using a novel technique of mesh augmentation for soft tissue repair. Methods: We reviewed 18 (mean age 64 years; 8 female: 10 male) consecutive patients undergoing PFR with Marlex mesh augmentation between 2018 and 2023 at a single institution. The most common indication was metastatic disease (n = 13). The mean follow-up in the 14 surviving patients was 27 months (range 12–34). Results: All patients were ambulatory at final follow-up. There were no post-operative dislocations, infections, or wound issues. At the final follow-up, the mean total MSTS score was 77%. Conclusion: Mesh augmentation of PFRs allowed for adequate soft tissue tensioning and muscular attachment to the body of the implant. In our series, this technique was durable, with no dislocations and no mesh-related complications. In summary, mesh augmentation of PFRs may be considered during reconstruction for oncologic indications. Full article
(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)
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10 pages, 2487 KiB  
Article
Augmented Reality Navigation System (SIRIO) for Neuroprotection in Vertebral Tumoral Ablation
by Eliodoro Faiella, Rebecca Casati, Matteo Pileri, Giuseppina Pacella, Carlo Altomare, Elva Vergantino, Amalia Bruno, Bruno Beomonte Zobel and Rosario Francesco Grasso
Curr. Oncol. 2024, 31(9), 5088-5097; https://doi.org/10.3390/curroncol31090376 - 30 Aug 2024
Viewed by 1632
Abstract
(1) This study evaluates the impact of the CT-guided SIRIO augmented reality navigation system on the procedural efficacy and clinical outcomes of neuroprotection in vertebral thermal ablation (RTA) for primary and metastatic bone tumors. (2) Methods: A retrospective non-randomized analysis of 28 vertebral [...] Read more.
(1) This study evaluates the impact of the CT-guided SIRIO augmented reality navigation system on the procedural efficacy and clinical outcomes of neuroprotection in vertebral thermal ablation (RTA) for primary and metastatic bone tumors. (2) Methods: A retrospective non-randomized analysis of 28 vertebral RTA procedures was conducted, comparing 12 SIRIO-assisted and 16 non-SIRIO-assisted procedures. The primary outcomes included dose-length product (DLP) and epidural dissection time. The secondary outcomes included technical success, complication rates, and pain scores at procedural time (VAS Time 0) and three months post-procedure (VAS Time 1). The statistical analyses included t-tests, Mann–Whitney U tests, and multiple regression. (3) Results: SIRIO-assisted procedures significantly reduced DLP (307.42 mGycm vs. 460.31 mGycm, p = 2.23 × 10−8) and procedural epidural dissection time (13.48 min vs. 32.26 min, p = 2.61 × 10−12) compared to non-SIRIO-assisted procedures. Multiple regression confirmed these reductions were significant (DLP: β = −162.38, p < 0.001; time: β = −18.25, p < 0.001). Pain scores (VAS Time 1) did not differ significantly between groups, and tumor type did not significantly influence outcomes. (4) Conclusions: The SIRIO system enhances neuroprotection efficacy and safety, reducing radiation dose and procedural time during spine tumoral ablation while maintaining consistent pain management outcomes. Full article
(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)
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17 pages, 707 KiB  
Systematic Review
Exploring the Efficacy of Combining Radiofrequency Thermal Ablation or Microwave Ablation with Vertebroplasty for Pain Control and Disease Management in Metastatic Bone Disease—A Systematic Review
by Eliodoro Faiella, Federica Vaccarino, Giuseppina Pacella, Domiziana Santucci, Elva Vergantino, Amalia Bruno, Raffaele Ragone, Bruno Beomonte Zobel and Rosario Francesco Grasso
Curr. Oncol. 2024, 31(9), 5422-5438; https://doi.org/10.3390/curroncol31090401 - 13 Sep 2024
Cited by 2 | Viewed by 1450
Abstract
Background: Interventional radiology techniques have become pivotal in recent years in managing metastatic bone disease, which frequently results in skeletal complications such as fractures and severe pain. Thermoablative methods like radiofrequency ablation (RFA) and microwave ablation (MWA), when combined with vertebroplasty (VP), are [...] Read more.
Background: Interventional radiology techniques have become pivotal in recent years in managing metastatic bone disease, which frequently results in skeletal complications such as fractures and severe pain. Thermoablative methods like radiofrequency ablation (RFA) and microwave ablation (MWA), when combined with vertebroplasty (VP), are proving increasingly beneficial for these patients. Methods: The search was independently conducted by two radiologists on MEDLINE databases, using specified strings up to April 2024. Methodological quality was assessed using PRISMA guidelines. Studies meeting inclusion criteria investigated thermoablation techniques (RFA and/or MWA) combined with VP, focusing on pain management and disease control outcomes in adults. Results: Among 147 results, 42 articles met the criteria, with varied prospective and retrospective designs and sample sizes averaging 49 patients, predominantly involving RFA (30 studies), MWA (11 studies), and one comparative study. Our review highlights significant pain reduction, effective local tumor control, and favorable safety of combined RFA or MWA with VP, supporting its potential in managing vertebral pathologies and warranting further clinical integration. Conclusions: The combined treatment of RFA/MWA with VP demonstrates significant pain reduction and local tumor control, with a rapid onset of analgesic effect. These findings support its crucial role in clinical practice for managing vertebral metastases. Full article
(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)
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