Patient Selection for Nonoperative Techniques Versus Operative Techniques
No studies met inclusion criteria to compare nonoperative vs operative treatment in the setting of metastatic disease of the humerus. Based on the lack of definitive evidence, no recommendations can be made for or against patient selection or indication for nonoperative vs. operative treatment pertaining to metastatic disease of the humerus.
Rationale
While specific literature is lacking, the group recommends that both nonoperative treatment and operative treatment can be considered based on the clinical circumstances of the patient, active comorbidities, metastatic disease burden and prognosis, location of the lesion, histologic subtype, presence of displacement or angulation, expected responsiveness to radiation and/or chemotherapy, and patient goals and expectations.
Future research such as prospective cohort studies could help elucidate the clinical scenarios in which patients can be treated successfully with nonoperative management for metastatic disease of the humerus.