Management of Bone Metastases

Prof. Vincenzo Denaro has been Full Professor in orthopaedic surgery and Dean at the University Campus Bio-Medico of Rome, and is one of the leading spine surgeons in Italy. His training included Professor Boni in Pavia, Professor Roy-Camille at the Hopital Pitie Salpetriere in Paris, and Prof. Macnab in Toronto. Being one of the founder members of the Cervical Spine Research Society of Europe, he has been President of the Italian Spine Society. His main fields of interest include the management of patients affected by Spinal and Tumor diseases. He is co-author of the National Guidelines on the management of bone metastases of the Italian Orthopaedic Society (S.I.O.T.), and of the Italian Association of Medical Oncology (A.I.O.M). He is author of more than 300 papers and book chapters, and has edited two books.Dr. Alberto Di Martino is Assistant Professor in orthopaedics and trauma surgery at University Campus Bio-Medico of Rome. His main fields of interests include spine andtumor surgery, and basic research. He has a PhD in tissue regeneration in Orthopaedics, and in currently involved in the osteoncology unit at the University Campus Bio-Medico of Rome. His training include a Spine research fellowship at Thomas Jefferson University and the Rothman Institute of Philadelphia (USA), and is currently involved in the Spine and Oncology programs with Prof. Vincenzo Denaro at the University Campus Bio-Medico of Rome. He is the Editorial Coordinator of the Italian Orthopaedic Society Bone Metastasis Study Group of the Italian Orthopaedic Society (S.I.O.T.). He has authored more than 80 manuscripts, and is co-author of the National Guidelines on the management of bone metastases of the S.I.O.T., and of the Italian Association of Medical Oncology (A.I.O.M). He currently is board member of several leading journals in the fields of spine and orthopaedics.Dr. Andrea Piccioli is an orthopaedic surgeon skilled in musculoskeletal oncology, trained at the Memorial Sloan Kettering Cancer Center of New York. He is the Secretary of Italian Society of Orthopedic and Traumatology (S.I.O.T.) and the Coordinator of the Working Group on Bone Metastasis of the Italian Society. He has been Orthopedic Oncologist Consultant in “Palazzo Baleani" Oncologic Unit of Policlinico Umberto I in Rome, and is currently member of the Scientific Committee of the “Istituto Superiore di Sanità”. He is the Director of the 3rd Office for Quality, Clinical Risk and Hospital Program, General Direction of Health Program, National Ministry of Health. He is the author of several scientific papers in the field of orthopaedic oncology and traumatology, and he is also responsible for the S.I.O.T. National Guidelines on Orthopaedic oncology. His main interests are on Musculoskeletal Oncology, and Public Health.

“For the radiologist with an interest in tumour work and impact of skeletal metastases, this is a well written and interesting book. … there are multiple informative images related to surgical management later on. The book is not expensive and for those interested in a more holistic understanding of the patient with metastatic bone disease, it highlights the newer treatments available that go hand in hand with the extended longevity for many cancer patients compared to 20 years ago.” (Prudencia Tyrell, RAD Magazine, September, 2019)

• Section I, Medical Treatment Of Bone Metastases: 1 Bone metastasis microenvironment .- 2 Cancer treatment induced bone loss.- 3 Bone targeted therapies in adjuvant setting.- 4 New therapeutic targets in metastatic setting.- 5 Pain in bone metastatic patients. Section II, Imaging / Radiology / Radiotherapy And Pathology: 6 The role of radiotherapy in bone metastasis.- 7 Pathology of bone metastasis.- 8 Pathology: difficult cases.- 9 Diagnostic imaging of bone metastases. Section III, Approach To The Patient: 10 The Pathfx project: decision analysis and Bayesian method in survival estimation.- 11 The choice of surgical procedure: how a surgeons choice is influenced by the expected survival.- 12 Metastases to the spine: algorithm of treatment.- 13 Metastases to the long bones: algorithm of treatment.- 14 Metastases to the pelvis: algorithm of treatment.- 15 Pathological vs Impending Fracture.- 16 Thromboprophylaxis in bone metastatic patients. Section IV, Surgery: 17 The timing of surgical treatment.- 18 Long bone metastasis.- 19 Spine Bone Metastasis Approach.- 20 Metastases to the sacrum and pelvis.- 21 New biomaterials in instrumentation systems: Carbon fiber intramedullary nail.- 22 New biomaterials in instrumentation system: Photodynamic Bone stabilization System.- 23 Fractures around tumor implants.- 24 Demolitive Surgery: is it an option?.- 25 Rehabilitation of patients with bone metastatic disease.- 26 Think, stage, then act.- 27 Pitfalls, Errors, and Unintended Consequences in the treatment of metastatic bone disease: how they occur and how they can be avoided. Section V, Minimally Invasive Tumor Treatment: 28 Interventional radiology, Thermoablation and Cryoablation.- 29 Electrochemotherapy.- 30 MRI-guided focused ultrasound surgery.- 31 New Palliative techniques: indications and limits.