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Comprehensive Management of Bone Tumours

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European Surgical Orthopaedics and Traumatology

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Abstract

Bone and soft tissue sarcoma are very rare entities. Their incidence is between 8 and 9 per million of the population for bone sarcomas, and 30 per million for soft tissue sarcomas. Together they constitute approximately 1 % of all malignant tumours and are therefore very difficult to both diagnose and manage [1]. Having said this there has been marked improvement in the management of both bone and soft tissue sarcomas over the past three decades as a result of better imaging, effective chemotherapy and the increasing use of limb salvage surgery. Centralising the management of patients in specialist units offers care by experienced multi-disciplinary teams and has been advocated by a number of national organisations, including the European Musculo Skeletal Oncology Society (EMSOS). As a result of such guidelines there is a broad consensus around the world on the optimal management of patients with these rare conditions. Where uncertainty still exists this can be explored by recruiting large numbers of patients into collaborative trials to try and resolve questions that could never be answered by single units.

The treatment for all bone tumours is surgical, with benign tumours being treated either by simple excision or by curettage and adjuvant therapy. This has been well described in other areas of this book. The management of malignant tumours, where there are at least 40 sub-types, is more complex and requires careful consideration of the use and timing of other adjuvant therapies in addition to surgery. Some form of limb salvage reconstruction is usually utilised in around 90 % of tumours, but around 10 % of malignant tumours still require amputation. Adjuvants which can be utilised in the management of malignant tumours include chemotherapy, radiation therapy and embolisation, which can be of considerable help in reducing surgical morbidity and on occasion in benign aggressive tumours may be curative.

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Authors and Affiliations

  1. Sarcoma Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK

    Stephen Cannon

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Correspondence to Stephen Cannon .

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  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

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Cannon, S. (2014). Comprehensive Management of Bone Tumours. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_181

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  • DOI: https://doi.org/10.1007/978-3-642-34746-7_181

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