Orthopedic Tumors & Sarcoma Surgery
Orthopedic oncology is one of University Hospital Cologne's main areas of specialization. We provide the full spectrum of diagnostic and therapeutic procedures for the treatment of tumors of the supporting apparatus and musculoskeletal system as well as secondary tumors (metastases). Orthopedic oncology also involves the diagnosis and treatment of benign bone and soft tissue tumors. In addition to the above, our department also provides second opinions for patients.
Our department is a German Cancer Society certified Tumor Center and all patient cases involving primary malignant bone tumors are presented to a multidisciplinary tumor board before treatment is commenced. During a tumor board meeting, the diagnostic findings for each patient are discussed by specialists from our internal medicine, (pediatric) oncology, surgery, pathology, radiology, nuclear medicine and radiation therapy departments to ensure that each patient receives the best medical treatment and care possible. We furthermore closely collaborate with the Hospital's plastic surgeons to ensure optimal cosmetic and functional surgery outcomes when performing complex soft tissue reconstructions.
These kinds of collaborations help us ensure that all of our healthcare services meet the highest quality standards, which are annually reviewed and certified by the German Cancer Society.
Acting as a Tumor Center in cooperation with the Center for Integrated Oncology (CIO) Köln Bonn, we have our own orthopedic-interdisciplinary tumor board and extensive experience in tumor surgery. In tumor disease, secondary treatment can, depending on the underlying diseases, be provided by the Hospital's Oncology and Radiotherapy departments.
All of our treatment recommendations are provided on the basis of the relevant specialist associations' treatment guidelines. Our department furthermore has its own treatment guidelines, which are developed by CIO specialists in interdisciplinary oncology project groups and are regularly updated in line with the latest research findings. In an effort to continually improve the treatment we provide, we also regularly conduct clinical trials to test and further enhance new medication and innovative treatment methods.
On occasion, the only viable treatment for a tumor affecting a major joint is to perform a full joint replacement. University Hospital Cologne offers the complete spectrum of artificial joint replacements. As a certified Center for Endoprosthetic Surgery (EndoCert®), we guarantee that prosthetic joints comply with the highest quality standards of the German Society for Orthopedics and Orthopedic Surgery (DGOOC). Our Endoprosthetic Department furthermore contributes to the German Endoprosthesis Register in order to contribute to health care research and patient safety.
Our treatment procedures at a glance
- Open and percutaneous bone and soft tissue biopsies
- Resection and reconstruction of sarcoma defects of the bone and soft tissues as well as of metastases
- Implantation and replacement of tumor endoprostheses
- Bone repair using biological procedures such as bone transplants and callus distraction
- Bone repair using alloplastic materials such as titanium diaphyseal replacement implants, intramedullary nailing and compound osteosyntheses
- Minimally invasive procedures such as radiofrequency ablation and kyphoplasty (in vertebral metastases)
- Removal of bone tumors from the spine and vertebral body replacement (en bloc spondylectomy)
Orthopedic Oncology Specializations
This section contains information on some of the conditions that we most frequently provide treatment for at our department.
The first step of the diagnostic process is to establish whether the tumor in question is malignant or a sarcoma and to identify the subgroup it belongs to. Sarcomas are very rare tumors and make up only about two percent of all newly forming tumors. These kinds of tissue tumors are divided into bone and soft tissue sarcomas and are subdivided on the basis of molecular-genetic, morphological and biological criteria.
At our department, sarcomas are diagnosed using radiological and nuclear-medicine diagnostic procedures such as Magnetic Resonance Imaging (MRI scans), Computed Tomography (CT scans), whole body skeletal scintiphotography and positron emission tomography (PET-CT). If a biopsy is required, it has to be performed by a Tumor Center such as ours, because an incorrectly performed biopsy can have extremely negative consequences on the tumor treatment provided. At our department, biopsied tumor tissue is assessed by experienced pathologists.
In order to choose the best possible treatment method, it is vital for a sarcoma to have been correctly classified. Once classified, the relevant treatment strategy will be decided interdisciplinarily and individually in the context of a tumor board.
The treatment strategy for primary malignant bone tumors depends on the location, histology and spread of the tumor and is planned individually for each patient. The personalized treatment recommendations made on the basis of the diagnostic findings will be implemented by a specialist with extensive experience in tumor surgery.
The surgery will be performed in such a way as to achieve the highest level of safety while at the same time being as gentle as possible and with the aim of preserving the affected extremity. The aim of surgical treatment for bone and soft tissue sarcoma is a wide resection of the tumor in the healthy tissue and subsequent reconstruction of the defect. In bone tumors, the latter is often achieved using tumor endoprostheses and bone replacement techniques (artificial bone replacements, bone transplants, callus distraction). Оur department also regularly performs cryosurgery.
Depending on the tumor's size and characteristics, the surgical treatment will be supported and complemented with either radiation or chemotherapy. This form of combination therapy is particularly decisive to the effective treatment of sarcomas.