Management of Metastatic Bone Disease

Abstract

Abstract:

The osseus skeleton is the 3^rd commonest site of metastasis due to malignancy, behind lung and liver.¹ Metastatic bone disease (MBD), also known as secondary bone cancer, is a common event which signals increased morbidity and early mortality². Recently, the duration of survival for patients with MBD has increased^{3, 4} likely due to advancements in medical and surgical techniques. MBD is therefore an increasingly common issue that orthopaedic surgeons are required to manage and investigate, and improvements in care have led to improved survival of this patient population. The British Orthopaedic Association (BOA) have issued guidelines on Management of MBD in 2015⁵ A recent audit of these guidelines demonstrated that current practice in the UK does not comply with national guidelines set out by British Orthopaedic Oncology Society (BOOS)/BOA¹. This article will outline presentation, investigation and current recommended treatment of MBD, as well as prognosis, and future possibilities in managing MBD. This narrative review article aims to improve awareness and details appropriate management for patients presenting with MBD for UK based clinicians and surgeons. 

References for abstract

1.Jayarangaiah A, Theetha Kariyanna P. Bone Metastasis [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507911/

‌2.Chansky HA. Metastatic Bone Disease: Practice Essentials, Pathophysiology and Etiology, Epidemiology [Internet]. Medscape.com. Medscape; 2024 [cited 2025 Mar 23]. Available from: https://emedicine.medscape.com/article/1253331-overview#a7?form=fpf

3. Storm HH, Kejs AMT, Engholm G, Tryggvadóttir L, Klint A, Bray F, et al. Trends in the overall survival of cancer patients diagnosed 1964-2003 in the Nordic countries followed up to the end of 2006: the importance of case-mix. Acta oncologica (Stockholm, Sweden) [Internet]. 2010 Jun;49(5):713–24. Available from: https://pubmed.ncbi.nlm.nih.gov/20491527/

4 . Rogers DL, Raad M, Rivera JA, Wedin R, Laitinen M, Sørensen MS, et al. Life Expectancy After Treatment of Metastatic Bone Disease: An International Trend Analysis. The Journal of the American Academy of Orthopaedic Surgeons [Internet]. 2024 Autumn;32(6):e293–301. Available from: https://pubmed.ncbi.nlm.nih.gov/38241634/

5.BOA. Management of Metastatic Bone Disease (MBD) [Internet]. BOA/BOOS; 2022 [cited 2025 Mar 23]. Available from: file:///C:/Users/7952080/AppData/Local/Temp/MicrosoftEdgeDownloads/00a0ed89-45d2-480a-a0a6-8b627fba7182/BOAST-Metastatic-Bone-Disease.pdf

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Authors: John Hannah , Adeel Akhtar and Phil Walmsley. Author Contributions: Conceptualization, JH, AA and PW; writing—original draft preparation, JH.; writing—review and editing, JH, AA and PW; visualization, JH and PW; supervision, AA and PW.; project administration, PW; All authors have read and agreed to the published version of the manuscript.

Funding: This article received no external funding

Conflicts of Interest: The authors declare no conflicts of interest.