{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:20Z","timestamp":1787027780744,"version":"build-2736575974"},"reference-count":127,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Advances in medical and surgical treatment have played a major role in increasing the survival rates of cancer patients with metastatic bone disease. The clinical course of patients with bone metastases is often impaired by bone complications, such as bone fractures, which have a substantial negative impact on clinical outcomes. To optimize clinical results and prevent a detrimental impact on patients\u2019 health, a tailored approach should be defined for any given patient. The optimal management of impending or pathologic fractures is unknown and relies on a multidisciplinary approach to tailor clinical decisions to each individual patient. The ability to control systemic disease, the extent, location and nature of bone metastases, and the biology of the underlying tumor, are the main factors that will define the strategy to follow. The present review covers the most recent data regarding impending and pathologic fractures in patients with bone metastases, and discusses the medical and surgical management of patients presenting with metastatic bone disease in different clinical settings.<\/jats:p>","DOI":"10.3390\/cancers14040893","type":"journal-article","created":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T20:32:30Z","timestamp":1644784350000},"page":"893","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A Tailored Approach for Appendicular Impending and Pathologic Fractures in Solid Cancer Metastases"],"prefix":"10.3390","volume":"14","author":[{"given":"Joaquim","family":"Soares do Brito","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Centro Hospitalar Universit\u00e1rio Lisboa Norte, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-3199","authenticated-orcid":false,"given":"Raquel","family":"Lopes-Br\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Centro Hospitalar Universit\u00e1rio Lisboa Norte, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Abrunhosa-Branquinho","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Centro Hospitalar Universit\u00e1rio Lisboa Norte, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Centro Hospitalar Universit\u00e1rio Lisboa Norte, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0985-0821","authenticated-orcid":false,"given":"In\u00eas","family":"Gomes","sequence":"additional","affiliation":[{"name":"Luis Costa Laboratory, Instituto de Medicina Molecular\u2014Jo\u00e3o Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6917-4477","authenticated-orcid":false,"given":"Sandra","family":"Casimiro","sequence":"additional","affiliation":[{"name":"Luis Costa Laboratory, Instituto de Medicina Molecular\u2014Jo\u00e3o Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00eds","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Centro Hospitalar Universit\u00e1rio Lisboa Norte, 1649-028 Lisbon, Portugal"},{"name":"Luis Costa Laboratory, Instituto de Medicina Molecular\u2014Jo\u00e3o Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.bonr.2016.02.003","article-title":"The insufficiencies of risk analysis of impending pathological fractures in patients with femoral metastases: A literature review","volume":"5","author":"Benca","year":"2016","journal-title":"Bone Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s10549-011-1475-5","article-title":"Survival in breast cancer patients with bone metastases and skeletal-related events: A population-based cohort study in Denmark (1999\u20132007)","volume":"129","author":"Yong","year":"2011","journal-title":"Breast Cancer Res. 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