[Basic principles of surgical treatment of bone metastases]

Due to an increased life expectancy and improved oncological treatment, the necessity for surgical treatment of bone metastases has increased as well. Ideally, therapy should concentrate on the improvement of the patient's quality of life while preferably being interdisciplinary. The type and extent of surgical therapy depend on the prognosis, tumor entity, localization of the tumor as well as on the patient's general condition. The main aims of surgical treatment is to reduce pain and preserve or restore function and mobility. After the contribution on spinal metastases in the last volume, this article focusses on metastases of the extremities and the pelvis. Pathologic fractures with an unclear oncological situation should be examined thoroughly before any surgical treatment is performed. In case of doubt, a biopsy should be performed. Depending on the individual prognosis, possible options for extremity surgery are (compound) osteosynthesis and implantation of a tumor endoprosthesis. The latter should be preferred for patients with a favorable prognosis and long life expectancy. To avoid revision surgery, the selected implant should outlast the patient's remaining life expectancy.