Overview
Metastatic malignant neoplasm to the ilium refers to cancer that has spread from its primary site to the ilium, a large bone in the pelvis. This condition can lead to pain, pathological fractures, and functional impairment.
Diagnosis
Imaging studies such as CT scans, MRI, or bone scans are typically used to identify metastatic lesions in the ilium 1.
Biopsy may be necessary for definitive diagnosis and to determine the primary tumor type 1.Management
Local consolidative therapy (LCT) has been shown to improve overall survival (OS) and progression-free survival (PFS) in patients with oligometastasis 1.
Pooled analyses of studies involving LCT showed improved OS (pooled odds ratio 2.896, 95% CI 2.377 to 3.528) and PFS (pooled odds ratio 3.045, 95% CI 2.356 to 3.937) 1.
Subgroup analyses limited to randomized controlled trials (RCTs) also favored LCT for OS (pooled odds ratio 1.535, 95% CI 1.082 to 2.177) and PFS (pooled odds ratio 1.668, 95% CI 1.187 to 2.344) 1.
Complication rates for LCT of grade ≥ 3 were generally low (<10%) and not significantly higher compared to control groups 1.Key Recommendations
Local consolidative therapy (LCT) should be considered for patients with oligometastatic disease, as it has demonstrated improved overall survival and progression-free survival 1. (Evidence: Strong)
The oncological efficacy of LCT is supported by meta-analyses of multiple studies, including randomized controlled trials 1. (Evidence: Strong)
The complication rate associated with LCT is generally low and comparable to control groups 1. (Evidence: Moderate)References
1 Rim CH, Cho WK, Lee JH, Kim YS, Suh YG, Kim KH et al.. Role of Local Treatment for Oligometastasis: A Comparability-Based Meta-Analysis. Cancer research and treatment 2022. link