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Clinical Efficiency Of Bone Reconstruction In Disseminated Metastatic Disease

Clinical Efficiency Of Bone Reconstruction In Disseminated Metastatic Disease. Re-written By: Daniel Habashi. It was hippocrates who first used the word “metastasis” and described it as a “ cahnge of place” in Corpus Hippocraticum.

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Clinical Efficiency Of Bone Reconstruction In Disseminated Metastatic Disease

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  1. Clinical Efficiency Of Bone Reconstruction In Disseminated Metastatic Disease Re-written By: Daniel Habashi

  2. It was hippocrates who first used the word “metastasis” and described it as a “cahnge of place” in Corpus Hippocraticum

  3. More precise knowledge of pathogenesis of metastatic disease was possible in XIX and XX centuries:

  4. S. Paget • S. Paget’s “seed and soil” theory based on 900 autopsies

  5. Malignant Bone Tumors In Poland – Scale Of The Problem • Primitive bone tumors • < 0.5% of all diagnosed malignancies +/- 100/year • Metastatic bone tumors • +/- 50% of all deaths due to npl = 45K/year

  6. Malignant Bone Tumors • Sarcomas vs. metastatic • Different histiogenesis (mesenchymal vs. epithelial) • Different prognosis / different indications • Common feature = multidisciplinary therapy

  7. Reconstruction And Limb Salvage Procedures • Total resection • Resection + arthroplasty • Modular (GMRS, MUTARS) • Bipolar with long stem • Standard +/- long stem • Resection + bone graft / cement + IF • Somectomy (resection of the whole vertebrae and implantation of a prosthetic vertebrae) + vertebral prosthesis + stabilization

  8. In many cases the functional result is better when we approach the metastasis as a primary lesion and treat it with wide resection and reconstruction

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