3ʳᵈ Edition of the Cancer R&D World Conference 2027

Abstract

Introduction: Treatment of primary malignant tumours without metastases is generally straight forward and can mostly follow established protocols. However, with metastases present, either syn- or metachronous, therapeutic decisions are highly individualized, hence more challenging. Rarely solitary sternum metastases are addressed by resection. Two additional cases are presented as they are interesting because of their long-term follow-up. Methods and Results:  Case 1: A renal cell carcinoma was treated by transabdominal nephrectomy at age 65. Right iliac bone and sternum metastases were treated by internal hemipelvectomy and by sternum metastasectomy 6 weeks later. At 12 years follow-up the patient appears diseasefree. Case 2: Prostate cancer was treated by prostatectomy at age 67. A subsequent solitary sternum metastasis was resected 10 years later for persistent PSA-activity despite repeated radiotherapy. The patient remains asymptomatic for 3 years now. Conclusion: Treatment of metastatic bone disease is challenging and needs an integrative approach. The occurrence of metastases is usually a sign of progressive disease. However, all treatment should primarily be curative. Aggressive local treatment of metastases may be indicated despite impaired prognosis for optimal local control but most importantly to preserve curative potential. Resection of sternum metastases, as in the presented cases with a positive long-term outcome, may have curative potential and should be considered in tumours known to be rather resistant to chemo- and/or radiotherapy.