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TumorDiagnostik & Therapie 2019; 40(04): 240-252
DOI: 10.1055/a-0885-0825
Thieme Onkologie aktuell
© Georg Thieme Verlag KG Stuttgart · New York

Skelettmetastasen der Extremitäten – Management und operative Behandlungskonzepte

Eric Jörg Walther
,
Hagen Fritzsche
,
Christine Hofbauer
,
Klaus-Dieter Schaser
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Publication History

Publication Date:
06 May 2019 (online)

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Zusammenfassung

Aufgrund der steigenden Anzahl an Tumorerkrankungen in Deutschland sowie der verlängerten Lebensdauer mit einer malignen Erkrankung sind Folgeerscheinungen wie Skelettmetastasen und pathologische Frakturen eine zunehmende klinische Herausforderung. Dieser Artikel stellt die Stufendiagnostik sowie die Behandlungsmöglichkeiten bei Patienten mit Skelettmetastasen der Extremitäten vor.

 

  • Literatur

  • 1 Robert-Koch-Institut. Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. Krebs in Deutschland 2011/2012. 10.. Aufl. Berlin: Robert-Koch-Institut; 2015
    Google Scholar
  • 2 Robert-Koch-Institut. Zentrum für Krebsregisterdaten. Im Internet: https://www.krebsdaten.de/Krebs/DE/Home/homepage_node.html ; Stand: 17.12.2017
    PubMedGoogle Scholar
  • 3 Coleman RE. Skeletal complications of malignancy. Cancer 1997; 80: 1588-1594
    CrossrefPubMedGoogle Scholar
  • 4 Ashford RU, Benjamin L, Pendlebury S. et al. The modern surgical and non-surgical management of appendicular skeletal metastases. Orthopaedics and Trauma 2012; 26: 184-199
    CrossrefPubMedGoogle Scholar
  • 5 Kufe DW, Pollock RE, Weichselbaum RR. et al. Holland-Frei Cancer Medicine. 6th . ed. Hamilton, Ont., Lewiston, NY: BC Decker; 2003
    Google Scholar
  • 6 Cancer ResearchUK. Cancer Statistics for the UK (2017). Im Internet: https://www.cancerresearchuk.org/#/ ; Stand: 17.12.2017
    PubMedGoogle Scholar
  • 7 American Cancer Society. Cancer stat facts (Juni 2017). Im Internet: https://seer.cancer.gov/statfacts/html/all.html ; Stand 17.12.2017
    PubMedGoogle Scholar
  • 8 Yang HL, Liu T, Wang XM. et al. Diagnosis of bonemetastases: a meta-analysis comparing 18 FDG PET, CT, MRI and bone scintigraphy. Eur Radiol 2011; 21: 2604-2617
    CrossrefPubMedGoogle Scholar
  • 9 Mitsuyoshi G, Naito N, Kawai A. et al. Accurate diagnosis of musculoskeletal lesions by core needle biopsy. J Surg Oncol 2006; 94: 21-27
    CrossrefPubMedGoogle Scholar
  • 10 Mankin HJ, Lange TA, Spanier SS. The classic: the hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. Clin Orthop Relat Res 2006; (450) 4-10
    PubMedGoogle Scholar
  • 11 Katagiri H, Okada R, Takagi T. et al. New prognostic factors and scoring system for patients with skeletal metastasis. Cancer Med 2014; 3: 1359-1367
    CrossrefPubMedGoogle Scholar
  • 12 Oken MM, Creech RH, Tormey DC. et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Amn J Clin Oncol 1982; 5: 649-656
    PubMedGoogle Scholar
  • 13 Mirels H. Metastatic disease in long bones: A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res 1989; (249) 256-264
    PubMedGoogle Scholar
  • 14 Ruggieri P, Mavrogenis AF, Casadei R. et al. Protocol of surgical treatment of long bone pathological fractures. Injury 2010; 41: 1161-1167
    CrossrefPubMedGoogle Scholar
  • 15 Capanna R, Campanacci DA. The treatment of metastases in the appendicular skeleton. J Bone Joint Surg Br 2001; 83: 471-481
    CrossrefPubMedGoogle Scholar
  • 16 Wedin R, Bauer HC, Wersäll P. Failures after operation for skeletal metastatic lesions of long bones. Clin Orthop Relat Res 1999; (358) 128-139
    PubMedGoogle Scholar
  • 17 Schwabe P, Ruppert M, Tsitsilonis S. et al. Surgical management and outcome of skeletal metastatic disease of the humerus. Acta Chir Orthop Traumatol Cech 2014; 81: 365-370
    PubMedGoogle Scholar
  • 18 Maerdian S, Schaser KD, Ruppert M. et al. Skeletal Metastatic Disease of the Femur: Results by Management with Intramedullary Nailing. Acta Chir Orthop Traumatol Cech 2015; 82: 192-197
    PubMedGoogle Scholar
  • 19 Piccioli A, Maccauro G, Rossi B. et al. Surgical treatment of pathologic fractures of humerus. Injury 2010; 41: 1112-1116
    CrossrefPubMedGoogle Scholar
  • 20 Pape A, Hofbauer C, Kleber C. et al. Der Stellenwert der klassischen Verbundosteosynthese langer Röhrenknochen und des Beckens. OP Journal 2017; 33: 11-17
    PubMedGoogle Scholar
  • 21 Wedin R, Hansen BH, Laitinen M. et al. Complications and survival after surgical treatment of 214 metastatic lesions of the humerus. J Shoulder Elbow Surg 2012; 21: 1049-1055
    CrossrefPubMedGoogle Scholar
  • 22 Scotti C, Camnasio F, Peretti GM. et al. Modular prostheses in the treatment of proximal humerus metastases: review of 40 cases. J Orthopaed Traumatol 2008; 9: 5-10
    CrossrefPubMedGoogle Scholar
  • 23 Gregory JJ, Ockendon M, Cribb GL. et al. The outcome of locking plate fixation for the treatment of periarticularmetastases. Acta Orthop Belg 2011; 77: 362-370
    PubMedGoogle Scholar
  • 24 Piccioli A, Rossi B, Scaramuzzo L. et al. Intramedullary nailing for treatment of pathologic femoral fractures due to metastases. Injury 2014; 45: 412-417
    CrossrefPubMedGoogle Scholar
  • 25 Afshar A, Farhadnia P, Khalkhali H. Metastases to the hand and wrist: an analysis of 221 cases. J Hand Surg Am 2014; 39: 923-932.e17
    CrossrefPubMedGoogle Scholar
  • 26 Schaser KD, Melcher I, Märdian S. et al. Komplikationsmanagement nach Resektion und Defektrekonstruktion hüftgelenknaher Tumoren. Orthopäde 2014; 43: 92-102
    CrossrefPubMedGoogle Scholar
  • 27 Weber KL, O'Connor MI. Operative Treatment of Long Bone Metastases. Clin Orthop Related Res 2003; 415: 276-278
    CrossrefPubMedGoogle Scholar
  • 28 Nilsson J, Gustafson P. Surgery for metastatic lesions of the femur: good outcome after 245 operations in 216 patients. Injury 2008; 39: 404-410
    CrossrefPubMedGoogle Scholar
  • 29 Bauer HCF. Controversies in the surgical management of skeletal metastases. J Bone Joint Surg Br 2005; 87: 608-617
    PubMedGoogle Scholar
  • 30 Kelly CM, Wilkins RM, Eckardt JJ. et al. Treatment of metastatic disease of the tibia. Clin Orthop Relat Res 2003; (415) 219-229
    PubMedGoogle Scholar
  • 31 Bryson DJ, Wicks L, Ashford RU. The investigation and management of suspected malignant pathological fractures: a review for the general orthopaedic surgeon. Injury 2015; 46: 1891-1899
    CrossrefPubMedGoogle Scholar
  • 32 Evans S, Ramasamy A, Jeys L. et al. Delayed diagnosis in metastatic lesions of the foot. Ann R Coll Surg Engl 2014; 96: 536-538
    CrossrefPubMedGoogle Scholar
  • 33 Ruggieri P, Mavrogenis AF, Casadei R. et al. Review of Foot Tumors Seen in a University Tumor Institute. J Foot Ankle Surg 2014; 53: 282-285
    CrossrefPubMedGoogle Scholar