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Published in: Supportive Care in Cancer 9/2019

01-09-2019 | Metastasis | Original Article

Ten-year experience of the multidisciplinary Osteoncology Center

Authors: Alberto Bongiovanni, Federica Recine, Valentina Fausti, Flavia Foca, Roberto Casadei, Maria Cristina Falasconi, Devil Oboldi, Elisabetta Sansoni, Laura Fabbri, Simona Micheletti, Stefano Severi, Federica Matteucci, Venetia Zavoiu, Laura Mercatali, Dino Amadori, Toni Ibrahim

Published in: Supportive Care in Cancer | Issue 9/2019

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Abstract

Purpose

Bone metastases (BMs) are responsible for high morbidity in patients. A multidisciplinary approach involving a team of specialists offers an effective therapeutic strategy based on disease characteristics, medical history, and performance status. We evaluated the impact of our 10-year multidisciplinary experience on the management of patients with BM.

Methods

We retrospectively analyzed 2194 medical reports of 1628 patients referred to our Osteoncology Center from 2005 to 2015. Cases were discussed weekly by a multidisciplinary team.

Results

Eight hundred thirty-eight (38.2%) of the 2194 visits were requested because of a risk of complications from BM. Antiblastic treatment and bone-targeted therapy were modified in 709 (66.3%) and 309 (31%) of cases, respectively. Radiotherapy was scheduled in 220 (20%) of the 1099 patients for whom information was recorded. Patients completed the Brief Pain Inventory (BPI) during their first visit, 1296 (59.1%) reporting pain (median intensity 4), and 537 (41.4%) experiencing a level that interfered substantially with daily activities. New ortheses and/or antalgic therapy was prescribed accordingly. After 7 days, 208 (16%) patients were re-evaluated and a new BPI administered. A significant improvement in the worst (p < 0.0001) and current pain (p = 0.03) was seen, together with a favorable impact on daily activities (p = 0.02). Two thousand fifty-one patients completed an anonymous questionnaire on the quality of the service, the majority (69.4%) expressing high satisfaction.

Conclusions

Our 10-year osteoncology experience confirms the importance of a multidisciplinary approach to optimize BM management. Further evaluations are needed in relation to quality of life, outcome, and costs.
Literature
1.
go back to reference Hart KB, Weiss K, Tekyi-Mensah S, Porter AT (1998) The epidemiology of bony metastases: a comparison of metastatic disease rates of the past 20 years. J Oncol Manag 7:26–28PubMed Hart KB, Weiss K, Tekyi-Mensah S, Porter AT (1998) The epidemiology of bony metastases: a comparison of metastatic disease rates of the past 20 years. J Oncol Manag 7:26–28PubMed
2.
go back to reference Mundy GR (2002) Metastasis to bone: causes, consequences and therapeutic opportunities. Nat Rev Cancer 2:584–593CrossRefPubMed Mundy GR (2002) Metastasis to bone: causes, consequences and therapeutic opportunities. Nat Rev Cancer 2:584–593CrossRefPubMed
3.
go back to reference Hosono N, Yonenobu K, Fuji T, Ebara S, Yamashita K, Ono K (1995) Orthopaedic management of spinal metastases. Clin Orthop Relat Res 312:148–159 Hosono N, Yonenobu K, Fuji T, Ebara S, Yamashita K, Ono K (1995) Orthopaedic management of spinal metastases. Clin Orthop Relat Res 312:148–159
4.
go back to reference Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12:6243–6249CrossRef Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12:6243–6249CrossRef
5.
go back to reference Harris K, Chow E, Zhang L, Velikova G, Bezjak A, Wu J, Barton M, Sezer O, Eek R, Shafiq J, Yee A, Clemons M, Brundage M, Hoskin P, van der Linden Y, Johnson CD, Bottomley A, EORTC Quality of Life Group (2009) Patients’ and health care professionals’ evaluation of health-related quality of life issues in bone metastases. Eur J Cancer 45:2510–2518CrossRefPubMed Harris K, Chow E, Zhang L, Velikova G, Bezjak A, Wu J, Barton M, Sezer O, Eek R, Shafiq J, Yee A, Clemons M, Brundage M, Hoskin P, van der Linden Y, Johnson CD, Bottomley A, EORTC Quality of Life Group (2009) Patients’ and health care professionals’ evaluation of health-related quality of life issues in bone metastases. Eur J Cancer 45:2510–2518CrossRefPubMed
6.
go back to reference Plunkett TA, Rubens RD (1999) The biology and management of bone metastases. Crit Rev Oncol Hematol 31:89–96CrossRefPubMed Plunkett TA, Rubens RD (1999) The biology and management of bone metastases. Crit Rev Oncol Hematol 31:89–96CrossRefPubMed
7.
go back to reference Caraceni A, Mendoza TR, Mencaglia E, Baratella C, Edwards K, Forjaz MJ, Martini C, Serlin RC, de Conno F, Cleeland CS (1996) A validation study of an Italian version of the Brief Pain Inventory (Breve Questionario per la Valutazione del Dolore). Pain 65:87–92CrossRefPubMed Caraceni A, Mendoza TR, Mencaglia E, Baratella C, Edwards K, Forjaz MJ, Martini C, Serlin RC, de Conno F, Cleeland CS (1996) A validation study of an Italian version of the Brief Pain Inventory (Breve Questionario per la Valutazione del Dolore). Pain 65:87–92CrossRefPubMed
8.
go back to reference Gerber LH, Vargo MM, Smith RG (2004) Rehabilitation of the cancer patient. In: DeVita VT Jr, Hellman S, Rosenberg SA (eds) Principles and practice of oncology, 7th edn. Lippincott Williams & Wilkins, Philadelphia Gerber LH, Vargo MM, Smith RG (2004) Rehabilitation of the cancer patient. In: DeVita VT Jr, Hellman S, Rosenberg SA (eds) Principles and practice of oncology, 7th edn. Lippincott Williams & Wilkins, Philadelphia
9.
go back to reference Casadei R (2003) Terapia chirurgica. In: Amadori D, Cascinu S, Conte PF (eds) Osteoncologia, un approccio multidisciplinare. Excerpta Medica, Milan Casadei R (2003) Terapia chirurgica. In: Amadori D, Cascinu S, Conte PF (eds) Osteoncologia, un approccio multidisciplinare. Excerpta Medica, Milan
10.
11.
go back to reference Ibrahim T, Flamini E, Fabbri L, Serra P, Mercatali L, Ricci R, Sacanna E, Falasconi MC, Casadei R, Galassi R, Giannini M, Bazzocchi O, Calzolari F, Nunziatini R, Gaudio M, Maltoni M, Amadori D (2009) Multidisciplinary approach to the treatment of bone metastases: Osteo-Oncology Center, a new organizational model. Tumori 95:291–297CrossRefPubMed Ibrahim T, Flamini E, Fabbri L, Serra P, Mercatali L, Ricci R, Sacanna E, Falasconi MC, Casadei R, Galassi R, Giannini M, Bazzocchi O, Calzolari F, Nunziatini R, Gaudio M, Maltoni M, Amadori D (2009) Multidisciplinary approach to the treatment of bone metastases: Osteo-Oncology Center, a new organizational model. Tumori 95:291–297CrossRefPubMed
12.
go back to reference Bongiovanni A, Foca F, Fantini M, Forcignano R, Silvestris F, Artioli F, Campadelli E, Daniele B, Ciotti F, Marcantognini G, Recine F, Fausti V, Vespignani R, Amadori D, Ibrahim T (2016) Italian perspective bone metastases (BM) database: the first one-year experience. ASCO Ann Meet 34:e13075 Bongiovanni A, Foca F, Fantini M, Forcignano R, Silvestris F, Artioli F, Campadelli E, Daniele B, Ciotti F, Marcantognini G, Recine F, Fausti V, Vespignani R, Amadori D, Ibrahim T (2016) Italian perspective bone metastases (BM) database: the first one-year experience. ASCO Ann Meet 34:e13075
13.
go back to reference Atkinson TM, Halabi S, Bennett AV, Rogak L, Sit L, Li Y, Kaplan E, Basch E, Cancer and Leukemia Group B (2012) Measurement of affective and activity pain interference using the Brief Pain Inventory (BPI): Cancer and Leukemia Group B 70903. Pain Med 13:1417–1424CrossRefPubMedPubMedCentral Atkinson TM, Halabi S, Bennett AV, Rogak L, Sit L, Li Y, Kaplan E, Basch E, Cancer and Leukemia Group B (2012) Measurement of affective and activity pain interference using the Brief Pain Inventory (BPI): Cancer and Leukemia Group B 70903. Pain Med 13:1417–1424CrossRefPubMedPubMedCentral
14.
go back to reference Mirels FI (1986) Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res 249:256–264 Mirels FI (1986) Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res 249:256–264
15.
go back to reference Asdourian PL (1997) Metastatic disease of the spine. In: Bridvvell KH, De Wald R (eds) The text- book of spinal surgery. Lippincott-Raven Publishers, Philadelphia Asdourian PL (1997) Metastatic disease of the spine. In: Bridvvell KH, De Wald R (eds) The text- book of spinal surgery. Lippincott-Raven Publishers, Philadelphia
16.
go back to reference Kostuik JP, Weistein IN (1991) Differential diagnosis and surgical treatment of metastatic spite tumors. In: Frymoyer JW (ed) The adult spine: principles and practice. Raven Press, New York Kostuik JP, Weistein IN (1991) Differential diagnosis and surgical treatment of metastatic spite tumors. In: Frymoyer JW (ed) The adult spine: principles and practice. Raven Press, New York
17.
go back to reference Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S (1990) Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine 15:1110–1113CrossRef Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S (1990) Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine 15:1110–1113CrossRef
18.
go back to reference Ibrahim T, Barbanti F, Giorgio-Marrano G, Mercatali L, Ronconi S, Vicini C, Amadori D (2008) Osteonecrosis of the jaw in patients with bone metastases treated with bisphosphonates: a retrospective study. Oncologist 13:330–336CrossRefPubMed Ibrahim T, Barbanti F, Giorgio-Marrano G, Mercatali L, Ronconi S, Vicini C, Amadori D (2008) Osteonecrosis of the jaw in patients with bone metastases treated with bisphosphonates: a retrospective study. Oncologist 13:330–336CrossRefPubMed
19.
go back to reference Kesson EM, Allardice GM, George WD, Burns HJ, Morrison DS (2012) Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ 344:e2718CrossRefPubMedPubMedCentral Kesson EM, Allardice GM, George WD, Burns HJ, Morrison DS (2012) Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ 344:e2718CrossRefPubMedPubMedCentral
21.
go back to reference Rubenstein LZ, Josephson KR, Wieland GD, English PA, Sayre JA, Kane RL (1984) Effectiveness of a geriatric evaluation unit: a randomized clinical trial. N Engl J Med 311:1664–1670CrossRefPubMed Rubenstein LZ, Josephson KR, Wieland GD, English PA, Sayre JA, Kane RL (1984) Effectiveness of a geriatric evaluation unit: a randomized clinical trial. N Engl J Med 311:1664–1670CrossRefPubMed
22.
go back to reference Chang JH, Vines E, Bertsch H, Fraker DL, Czerniecki BJ, Rosato EF, Lawton T, Conant EF, Orel SG, Schuchter L, Fox KR, Zieber N, Glick JH, Solin LJ (2001) The impact of multidisciplinary breast cancer center on recommendations for patient management: the University of Pennsylvania experience. Cancer 91:1231–1237CrossRefPubMed Chang JH, Vines E, Bertsch H, Fraker DL, Czerniecki BJ, Rosato EF, Lawton T, Conant EF, Orel SG, Schuchter L, Fox KR, Zieber N, Glick JH, Solin LJ (2001) The impact of multidisciplinary breast cancer center on recommendations for patient management: the University of Pennsylvania experience. Cancer 91:1231–1237CrossRefPubMed
23.
go back to reference Ruhstaller T, Roe H, Thürlimann B, Nicoll JJ (2006) The multidisciplinary meeting: an indispensable aid to communication between different specialities. Eur J Cancer 42:2459–2462CrossRefPubMed Ruhstaller T, Roe H, Thürlimann B, Nicoll JJ (2006) The multidisciplinary meeting: an indispensable aid to communication between different specialities. Eur J Cancer 42:2459–2462CrossRefPubMed
24.
go back to reference Raman S, Ding K, Chow E, Meyer RM, Nabid A, Chabot P, Coulombe G, Ahmed S, Kuk J, Dar AR, Mahmud A, Fairchild A, Wilson CF, Wu JS, Dennis K, DeAngelis C, Wong RK, Zhu L, Brundage M (2016) A prospective study validating the EORTC QLQ-BM22 bone metastases module in patients with painful bone metastases undergoing palliative radiotherapy. Radiother Oncol 119:208–212CrossRefPubMed Raman S, Ding K, Chow E, Meyer RM, Nabid A, Chabot P, Coulombe G, Ahmed S, Kuk J, Dar AR, Mahmud A, Fairchild A, Wilson CF, Wu JS, Dennis K, DeAngelis C, Wong RK, Zhu L, Brundage M (2016) A prospective study validating the EORTC QLQ-BM22 bone metastases module in patients with painful bone metastases undergoing palliative radiotherapy. Radiother Oncol 119:208–212CrossRefPubMed
25.
go back to reference Raman S, Ding K, Chow E, Meyer RM, van der Linden YM, Roos D, Hartsell WF, Hoskin P, Wu JSY, Nabid A, Haas R, Wiggenraad R, Babington S, Demas WF, Wilson CF, Wong RKS, Zhu L, Brundage M (2018) Minimal clinically important differences in the EORTC QLQ-C30 and brief pain inventory in patients undergoing re-irradiation for painful bone metastases. Qual Life Res 27:1089–1098CrossRefPubMed Raman S, Ding K, Chow E, Meyer RM, van der Linden YM, Roos D, Hartsell WF, Hoskin P, Wu JSY, Nabid A, Haas R, Wiggenraad R, Babington S, Demas WF, Wilson CF, Wong RKS, Zhu L, Brundage M (2018) Minimal clinically important differences in the EORTC QLQ-C30 and brief pain inventory in patients undergoing re-irradiation for painful bone metastases. Qual Life Res 27:1089–1098CrossRefPubMed
Metadata
Title
Ten-year experience of the multidisciplinary Osteoncology Center
Authors
Alberto Bongiovanni
Federica Recine
Valentina Fausti
Flavia Foca
Roberto Casadei
Maria Cristina Falasconi
Devil Oboldi
Elisabetta Sansoni
Laura Fabbri
Simona Micheletti
Stefano Severi
Federica Matteucci
Venetia Zavoiu
Laura Mercatali
Dino Amadori
Toni Ibrahim
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Keyword
Metastasis
Published in
Supportive Care in Cancer / Issue 9/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-019-4635-5

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