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Eur J Trauma Emerg Surg · Aug 2024
ReviewManagement of metastatic bone disease of the pelvis: current concepts.
- Hüseyin Bilgehan Çevik, Pietro Ruggieri, and Peter V Giannoudis.
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Turkey. bilgehancevik@gmail.com.
- Eur J Trauma Emerg Surg. 2024 Aug 1; 50 (4): 127712941277-1294.
PurposeMetastatic disease of the pelvis is frequently associated with severe pain and impaired ambulatory function. Depending on the patient's characteristics, primary tumor, and metastatic pelvic disease, the treatment choice may be varied. This study aims to report on the current management options of metastatic pelvic disease.MethodsWe comprehensively researched multiple databases and evaluated essential studies about current concepts of managing a metastatic bone disease of the pelvis, focusing on specific indications as well as on the result of treatment.ResultsPelvic metastases not in the periacetabular region can be managed with modification of weight-bearing, analgesics, bisphosphonates, chemotherapy and/or radiotherapy. Minimally invasive approaches include radiofrequency ablation, cryoablation, embolization, percutaneous osteoplasty, and percutaneous screw placement. Pathological or impending periacetabular fracture, excessive periacetabular bone defect, radioresistant tumor, and persistent debilitating pain despite non-surgical treatment and/or minimally invasive procedures can be managed with different surgical techniques. Overall, treatment can be divided into nonoperative, minimally invasive, and operative based on specific indications, the expectations of the patient and the lesion.ConclusionDifferent treatment modalities exist to manage metastatic pelvic bone disease. Decision-making for the most appropriate treatment should be made with a multidisciplinary approach based on a case-by-case basis.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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