Indicazioni chirurgiche nelle localizzazioni scheletriche delle malattie emolinfoproliferative.

Background: hematologic malignancies have a very good response to chemotherapy and radiotherapy, and surgery is only used for the symptomatic treatment or prevention of fractures. Objectives: to analyze indications and complications of surgery as treatment of bone lesions in these patients. Methods: were analyzed 214 patients (120 males, 94 females), surgically treated between 1985 and 2009. Mean age at diagnosis was 51 years (range 7-86 years). The histopathological entities were grouped into 3 groups: lymphomas (86 patients), multiple myeloma (77 patients) and solitary plasmacytoma (51 patients). Type of surgery was closely related to the lesion (44% lower limb, 34% spine, 16% upper limb, trunk 6%) and to the histotype. Results: at a mean follow-up of 3.7 years, the incidence of complications was 12.1% (26 patients). No perioperative deaths were observed. Conclusion: chemotherapy and radiotherapy, often combined, are the major therapeutic weapons. Surgery has only an “oncologic” role in low-grade or lonely lesions. In the other cases, aim of surgery is to prevent or improve the functional status of the patient. Therefore, it is used for lesions at risk of fracture, pathological fractures, risk or symptoms of neurological deficit.