bims-rebome 2025-12-28 papers

J Orthop. 2026 Feb;72 383-391

The 50 most cited articles on long bone metastatic disease: A bibliometric analyses.

Nicolaas Kotze, Alexander Price, Xander van Heerden, Ruairí Mac Niocaill, Paddy Kenny, Joseph Queally, Andrew Hughes.

Introduction: This bibliometric analysis seeks to provide a thorough examination of the research landscape pertaining to long bone metastatic disease. Given the rising prevalence of skeletal metastases, it is imperative to evaluate existing research to guide future research endevours.
Methods: In August 2025, a comprehensive literature search was conducted using Publish or Perish software to access Google Scholar, focusing on the keyword "long bone metastatic disease." A total of the 50 highest cited articles were identified based on defined inclusion criteria. Citation metrics, study designs, and geographic distribution were analyzed, and keyword co-occurrence analysis was employed to find primary thematic areas.
Results: The findings show an increase in publication activity starting in the early 2000s, paralleling advancements in oncological treatments that have improved survival outcomes. Among the top articles, 64 % utilized retrospective cohort designs, and no randomized controlled trials (RCTs) were found. The geographical analysis revealed a significant concentration of publications from North America and Western Europe, which comprised over 70 % of the literature, whilst contributions from low- and middle-income countries were notably sparse. The keyword co-occurrence analysis highlighted three predominant thematic clusters: surgical management, prognostic considerations, and outcomes/complications.Discussion:This analysis underscores the prevalent focus on surgical management strategies, particularly regarding the treatment and prevention of pathological fractures in patients with long bone metastases. However, the lack of high-level evidence combined with limited representation from diverse populations signals crucial gaps that must be addressed in future research endeavors.
Conclusion: This bibliometric review offers a comprehensive overview of the influential literature surrounding long bone metastatic disease, revealing significant trends and identifying critical shortcomings. Future investigations should concentrate on generating high-level evidence while enhancing inclusivity in research populations, thus ensuring management strategies are effective and aligned with the holistic needs of patients enduring this complex condition.

DOI: https://doi.org/10.1016/j.jor.2025.11.033

Zhonghua Zhong Liu Za Zhi. 2025 Dec 23. 47(12): 1152-1165

[Clinical pathway and expert consensus on the diagnosis and treatment of bone metastases from lung cancer (2025 edition)].

Chinese Society of Clinical Oncology Non-Small Cell Lung Cancer Professional Committee

Bone metastasis from lung cancer is one of the common complications in patients with advanced lung cancer, which can lead to pathological fractures, spinal cord compression, bone surgery, bone radiotherapy, and other skeletal related events (SREs), severely affecting the quality of life and prognosis of patients. The Non-Small Cell Lung Cancer Committee of the Chinese Society of Clinical Oncology convened a multidisciplinary expert panel comprising specialists from respiratory medicine, oncology, orthopedics, radiation oncology, nuclear medicine, radiology, and oral and maxillofacial surgery to develop this consensus. It is based on domestic and international evidence-based medicine and clinical practice experience, and was formulated through repeated consultations and thorough discussions. The consensus provides nine recommendations from six perspectives: diagnosis, screening, treatment strategies, bone-targeted drug treatment strategies and management of adverse reactions, local treatment, and efficacy evaluation. These recommendations are intended for reference and used by relevant medical personnel. The development of this consensus aims to provide scientific and practical guidance for clinicians, with the expectation of improving the quality of life and prognosis of patients.

DOI: https://doi.org/10.3760/cma.j.cn112152-20250623-00286

Orthop Rev (Pavia). 2025 ;17 150315

Radiofrequency Ablation and Cryoablation in Treating Painful Bone Metastasis: A Comprehensive Systematic Review and Separate Single-Arm Meta-analysis.

Motaz Alaqeel, Abdullah Alnajres, Yara Mulia, Mishari Alanezi, Shaikhah Alsenani, Farah Alqazlan, Mohammad Aljarba, Waleed Albishi, Ibrahim Alshaygy, Abdulrahman Alaseem.

Background and Aim: Bone metastases cause pain and disability in advanced prostate, breast, and lung cancers. Traditional treatments may not work for all patients. Minimally invasive procedures such as cryoablation (CA) and radiofrequency ablation (RFA) have emerged as good options. This review aims to evaluate and summarize the effectiveness and safety of CA and RFA separately in managing painful bone metastases.
Methods: We performed a comprehensive search of Ovid Medline, Google Scholar, Web of Science, CENTRAL, and ClinicalTrials.gov covering studies published between January 2000 and January 2025. The search included English-language cohorts. or randomized trials of adults (≥18 years) with bone metastases treated using RFA or CA. Outcomes such as pain levels, tumor recurrence, and adverse events were collected from each study. To assess the quality and reliability of the studies, we used the Cochrane Risk of Bias 2 (RoB 2) tool for randomized trials and the ROBINS-I tool for nonrandomized studies. We performed separate single-arm meta-analyses for RFA and for CA and integrated findings from the small number of direct comparative studies using a narrative synthesis.We performed separate single-arm meta-analyses for RFA and for CA and integrated findings from the small number of direct comparative cohort studies using a narrative synthesis.
Results: A total of 30 studies involving 1121 patients were included in the qualitative synthesis, and 24 were included in the meta-analysis. Separate single-arm meta-analyses revealed that both radiofrequency ablation (RFA) and cryoablation (CA) significantly reduced pain at all follow-up timepoints. RFA had the greatest pain reduction at 6 months (SMD: -3.50; 95% CI: -4.42, -2.27), whereas CA had a greater effect at 24 hours (SMD: -2.43; 95% CI: -3.84, -1.02) but ,a smaller effect at 6 months (SMD: -2.14; 95% CI: -3.43, -0.85). Both were safe, with mostly mild adverse events. The reported tumor control outcomes have been inconsistent, limiting conclusions in this area.
Conclusion: On separate analyses, CA appeared to produce larger short-term effect sizes (greater early pain reduction) while RFA had larger medium/long-term effect sizes in the available studies. Because direct comparative data are sparse and heterogeneous, these observations do not establish superiority of one modality over the other. Both techniques demonstrated favorable safety profiles across included studies. Ablation combined with external beam radiation therapy (EBRT) was superior to either modality alone. Standardized measures and more comparative studies are needed to guide treatment.

Keywords: : Bone metastases; cryoablation; local tumor control; pain management; radioablation; thermal ablation

DOI: https://doi.org/10.52965/001c.150315

Global Spine J. 2025 Dec 26. 21925682251410472

Updating Prognostic Assessment for Spinal Metastases With a Combined Model of the Spinal Instability Neoplastic Score and the New Katagiri Score.

Kazuya Yokota, Yuzo Kugimoto, Kiyoshi Tarukado, Kazu Kobayakawa, Hirokazu Saiwai, Kenichi Kawaguchi, Makoto Endo, Toshifumi Fujiwara, Akira Nabeshima, Nobuhiko Yokoyama, Yasuharu Nakashima.

Study DesignProspective Cohort Study.ObjectivesThe rapidly evolving landscape of cancer care alters the prognostic accuracy of established scoring systems for metastatic spinal tumors. This study aimed to provide a contemporary assessment of patient survival and examine the independent and complementary roles of the new Katagiri score (a systemic prognostic tool) and the Spinal Instability Neoplastic Score (SINS, a mechanical instability tool) in predicting 6-month mortality, laying a foundation for future combined prognostic model development.MethodsWe prospectively analyzed 151 patients with metastatic spinal tumors treated between 2021 and 2023. Demographic, clinical, and treatment data, including the new Katagiri score and SINS, were collected. The primary endpoint was 6-month mortality, which was evaluated using trend tests, correlation, and multivariate logistic regression.ResultsThe 6-month mortality rate was 25.17%. Higher scores in both the new Katagiri score and the SINS were significantly associated with an increased risk of 6-month mortality. Notably, no significant correlation was observed between the total Katagiri score and the total SINS. Stratified analyses showed that prognostic factors for early mortality differed across new Katagiri score risk groups, with varying influences from specific Katagiri score items, SINS components, and spinal metastasis levels. SINS-related factors had a significant impact in the high-risk group.ConclusionsThe new Katagiri score and SINS independently predicted 6-month mortality in our cohort. Our findings suggest that considering both complementary measures may further refine prognostic assessment, providing a rationale for future prospective model development and validation.

Keywords: metastatic spinal tumors; new katagiri score; prognostic prediction; spinal instability neoplastic score (SINS); survival

DOI: https://doi.org/10.1177/21925682251410472

J Oncol Pharm Pract. 2025 Dec 23. 10781552251399902

Timing of bone-modifying agents after bone metastasis diagnosis and time to first skeletal-related event: A systematic review and study-level correlation analysis.

Junya Sato, Tatsuki Ikeda, Satoru Nihei, Rei Tanaka, Kenta Murotani, Kenzo Kudo, Dan Kanehira, Teruhisa Azuma, Hiroyuki Shibata.

IntroductionBone-modifying agents (BMAs) effectively prevent skeletal-related events (SREs) in bone metastases (BMs). While early BMA use is recommended upon BM diagnosis, its benefits and optimal timing remain unclear. This study investigated whether early BMA initiation after BM diagnosis delays SRE onset by analyzing pooled data from placebo-controlled trials.MethodsRandomized controlled trials in which a BMA or placebo was administered after BM diagnosis were extracted. For each trial's BMA and placebo arms, the waiting period from BM diagnosis to BMA initiation and the effective period from BMA initiation to SRE onset were investigated. The hazard ratio (HR) for the SRE-free period relative to the placebo period was calculated. A waiting period of ≤6 months was defined as the early initiation group, whereas that of >6 months was the delayed initiation group. The HRs were meta-analyzed.ResultsData from 17 studies were analyzed. Early initiation of BMAs showed a trend toward a longer duration of efficacy compared with delayed initiation (+5.5 versus [vs.] + 3.2 months, p = 0.056). However, the pooled HR demonstrated efficacy at both initiation timepoints (0.62 [0.56-0.69] vs. 0.73 [0.60-0.83]).ConclusionsAlthough early initiation of a BMA after BM diagnosis is recommended, its efficacy-specifically whether it prolongs the time to SRE onset-remains unclear.

Keywords: BMA; Bone-modifying agent; SRE; bisphosphonate; bone metastasis; early use; skeletal-related event

DOI: https://doi.org/10.1177/10781552251399902