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Metastatic bone disease--the orthopaedic workload.

G L Cribb1, A D Toms, G Prosser

  • 1Department of Trauma and Orthopaedics, New Cross Hospital, Wolverhampton, UK.

Annals of the Royal College of Surgeons of England
|November 6, 2004
PubMed
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Metastatic bone disease presents a significant workload for orthopaedic departments. Current British Association of Surgical Oncology (BASO) guidelines for breast cancer are generally followed and could be extended to other cancers.

Area of Science:

  • Orthopaedic Surgery
  • Oncology
  • Multidisciplinary Care

Background:

  • Established British Association of Surgical Oncology (BASO) guidelines in 1999 for metastatic bone disease in breast cancer.
  • Emphasized the orthopaedic surgeon's role within the multidisciplinary team.

Purpose of the Study:

  • To quantify the workload associated with metastatic bone disease in an orthopaedic department.
  • To assess adherence to BASO guidelines for metastatic breast disease.
  • To explore the applicability of BASO recommendations to other metastatic bone diseases.

Main Methods:

  • Prospective study over a 6-month period.
  • Analysis of patient referrals, length of stay, and adherence to guidelines.
  • Comparison with patients discussed in multidisciplinary meetings and those presenting to oncology.

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Main Results:

  • 36 patients referred to orthopaedics; most were emergencies.
  • High initial orthopaedic consultant review rate (83%), but low cancer liaison consultant review (27%).
  • Only 16 patients required surgery; prolonged length of stay linked to unknown primary carcinoma.

Conclusions:

  • Metastatic bone disease constitutes a substantial workload for orthopaedic departments.
  • BASO guidelines for breast cancer are largely followed and potentially extendable to other tumors.
  • Adequate resources are crucial for maintaining high-quality, timely care for metastatic bone disease.