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Management of Bone Metastases pp 149–157Cite as

Megaprosthesis for Metastasis of the Lower Limb

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Abstract

In the past, the surgical approach to bone metastasis had the sole purpose to solve a biomechanical problem because the patient would die for systemic disease progression. Intramedullary nailing was the mainstay of the treatment, and its aim was allowing the patient to stand, with local tumor control achieved by radiotherapy [1, 2]. The improvement of medical therapy, radiotherapy and new diagnostic techniques have led to an increment of global life expectancy in bone metastatic patients, so complications related to the first surgery, often requiring further surgeries, are more common (Fig.1) [3, 5].Today, the surgeon has to take the possibility of a long survival into account, moreover if the patient has just one bone metastatic disease; this means performing more resections with wide margins and prosthetic reconstruction than before [6].Resection has to be considered after taking account of several factors which have to be evaluated from a multidisciplinary point of view and considering life expectancy: the oncologist, the orthopedic surgeon, the pathologist, the radiotherapist and the anesthesiologist are the main protagonists. The final decision has to be taken by the patient, once correctly informed about advantages and disadvantages of the possible procedures [7].

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Authors and Affiliations

  1. Oncological Ortopedics, Regina Elena National Cancer Institute, Rome, Italy

    Carmine Zoccali, Dario Attala & Roberto Biagini

  2. School of Medicine, Tor Vergata University, Rome, Italy

    Alessandra Scotto

Authors
  1. Carmine Zoccali
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  2. Dario Attala
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  3. Alessandra Scotto
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  4. Roberto Biagini
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Corresponding author

Correspondence to Roberto Biagini .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy

    Vincenzo Denaro

  2. Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy

    Alberto Di Martino

  3. General Direction of Health Program, National Ministry of Health of Italy, Rome, Italy

    Andrea Piccioli

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Zoccali, C., Attala, D., Scotto, A., Biagini, R. (2019). Megaprosthesis for Metastasis of the Lower Limb. In: Denaro, V., Di Martino, A., Piccioli, A. (eds) Management of Bone Metastases. Springer, Cham. https://doi.org/10.1007/978-3-319-73485-9_14

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  • DOI: https://doi.org/10.1007/978-3-319-73485-9_14

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  • Online ISBN: 978-3-319-73485-9

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