Department of Orthopedic Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Cancer Control. 2012 Apr;19(2):113-21. doi: 10.1177/107327481201900205.
Nonvertebral osseous metastases can result in pain and disability. The goals of surgical intervention are to reduce pain and to improve function if nonsurgical treatment fails. The indications for proceeding with surgical intervention depend on anatomic location, amount of local destruction, extent of skeletal and visceral disease and, most important, the patient's performance status and life expectancy.
This article reviews the evaluation and treatment of metastatic nonvertebral osseous lesions from the perspective of the orthopedic surgeon, based mainly on an assessment of the surgical literature.
This article summarizes the approaches to preoperative evaluation, patient selection, and medical optimization. Guidelines for estimating osseous stability and fracture risk are discussed, and surgical implants and their relation to postoperative outcomes are examined. This review also describes less invasive ablative procedures currently available.
The surgical management of nonvertebral osseous metastases involves multidisciplinary collaboration. The surgical construct must be a stable, reliable, and durable intervention that is individually tailored and matched to a patient's prognosis and performance status.
非脊柱骨转移可导致疼痛和残疾。手术干预的目的是减轻疼痛，并在非手术治疗失败时改善功能。手术干预的适应证取决于解剖部位、局部破坏程度、骨骼和内脏疾病的范围，最重要的是患者的身体状况和预期寿命。
本文主要基于对骨科文献的评估，从骨科医生的角度回顾了转移性非脊柱骨病变的评估和治疗。
本文总结了术前评估、患者选择和医学优化的方法。讨论了评估骨稳定性和骨折风险的指南，并研究了外科植入物及其与术后结果的关系。本综述还描述了目前可用的微创消融术。
非脊柱骨转移的手术治疗涉及多学科合作。外科结构必须是一种稳定、可靠和耐用的干预措施，根据患者的预后和身体状况进行个体化设计和匹配。
