Multidisciplinary approach to bone metastases: a single center experience in a tertiary cancer center

Purpose: The increasing incidence of bone metastases frequently leads to skeletal-related events (SREs) and pain. While multidisciplinary management is recommended by scientific societies, a standardized model remains undefined. An example can be provided by the Osteoncology multidisciplinary outpatient clinic (OMC) of the Veneto Oncology Institute, created to offer support to patients with bone metastases. Patients and methods: Patients with bone metastases are evaluated by a multidisciplinary team since 2013. Access to the OMC is regulated by an internal protocol and a form filled out by the referring physicians, which establishes the priority of access and the specific query for the multidisciplinary team. We analyzed the characteristics and outcome of OMC visits of all patients who accessed between January 2018 and June 2023. All data were retrieved from a prospectively managed database. Results: 2,200 patients were evaluated at OMC, with a median age of 66 years. Breast (33.3%) and lung cancer (19.2%) were the most frequent primary sites. Most patients (85.1%) accessed the OMC in line with the priority indicated by their referral score, with a median waiting time of 6 days. Physicians most frequently asked the multidisciplinary team about the best treatment for bone metastases; 35% sent multiple requests. Following OMC visit, 31.5% of patients received two or more distinct indications. The most frequent were orthopedic corsets (28.3%) and radiotherapy (27.5%). Conclusion: This large series confirms the efficacy of a multidisciplinary approach for bone metastases. This method reduces patients' psychophysical stress through rapid and effective assessment and provide precise and tailored therapeutic indications.