Materiały źródłowe

• #1 Metastatic bone disease – epidemiology, characteristic…

  https://polishorthopaedics.pl/seo/article/545215/en

  Metastatic bone disease (MBD) is a common problem among patients with malignant tumors. Bone tissue is the third most frequent site of metastasis, following the lungs and liver. The risk of bone metastases increases with the duration of the cancer disease. Early diagnosis should be implemented when a patient with malignant tumors reports symptoms such as bone pain, joint mobility disorders, or neurological symptoms. Attention should also be drawn to abnormalities in laboratory tests – elevated calcium levels in serum (hypercalcemia). In the case of fractures in atypical locations or occurring after low-energy trauma, oncological disease should be included in the differential diagnosis. The first-line imaging studies include X-rays and computed tomography. Magnetic resonance imaging is recommended in cases of diagnostic uncertainty or changes in the axial skeleton. Additionally, scintigraphy allows for determining the nature of the lesion and oncological staging (assessment of the number of metastatic lesions to the bones). Hybrid studies are also used, characterized by the best sensitivity and specificity parameters. If dealing with a tumor of unknown origin, the most important diagnostic step is biopsy, which should be performed by an experienced clinician at a bone cancer treatment center. The authors of the publication hope that the review presented below will help expand knowledge about MBD, optimize its diagnostic process, and improve medical care in Poland for patients with metastatic bone disease.

• #2 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  Bone is the third most common organ affected by metastasis, after the lungs and liver. While skeletal metastases can occur in almost any malignancy, the most common cancers that spread to bone are prostate, breast, lung, kidney and thyroid. Among these malignancies, breast, prostate and lung have the highest incidence in the US, and represent roughly 70% of the cases of metastatic bone disease (MBD) seen by clinicians. Population-based estimates of the prevalence of patients with bone metastases secondary to solid tumors in the US are limited. Nonetheless, recent literature estimates the prevalence of MBD in the U.S. in a given year to be somewhere between 300,000 and 600,000 cases. Roughly, 56% of breast cancer patients present with MBD at diagnosis and among those who present without metastatic disease, the risk of developing skeletal metastases increases at 5, 10 and 15 years (6.5%, 10.5% and 12% respectively). In addition to breast cancer, a significant portion of patients with advanced prostate, lung, thyroid, renal and bladder carcinoma also have MBD. These numbers, however, likely underestimate MBD, as autopsy studies may suggest that the incidence of bone metastases in patients who die of cancer is close to 70%. Additionally, improved screening methods and advanced treatments have subsequently led to both more accurate detection and improved survival, therefore increasing the incidence of MBD.

• #3 Epidemiology of bone metastases – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33276151/

  Background: This study evaluated the incidence of de novo bone metastasis across all primary cancer sites and their impact on survival by primary cancer site, age, race, and sex. […] Our objectives were (I) characterize the epidemiology of de novo bone metastasis with respect to patient demographics, (II) characterize the incidence by primary site, age, and sex (2010-2015), and (III) compare survival of de novo metastatic cancer patients with and without bone metastasis. […] Of patients with cancer in the SEER database, 5.1% were diagnosed with metastasis to bone, equaling ~18.8 per 100,000 bone metastasis diagnoses in the US per year (2010-2015). […] The presence of de novo bone metastasis was associated with a limited reduction in overall survival (HR = 1.02, 95%, CI = [1.01-1.03], p 0.001) when compared to patients with other non-bone metastases. […] The presence of bone metastasis versus metastasis to other sites has disease site-specific impact on survival. The incidence of de novo bone metastasis varies by age, sex, and primary disease site.

• #4 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  Bone is the third most common organ affected by metastasis, after the lungs and liver. While skeletal metastases can occur in almost any malignancy, the most common cancers that spread to bone are prostate, breast, lung, kidney and thyroid. Among these malignancies, breast, prostate and lung have the highest incidence in the US, and represent roughly 70% of the cases of metastatic bone disease (MBD) seen by clinicians. Population-based estimates of the prevalence of patients with bone metastases secondary to solid tumors in the US are limited. Nonetheless, recent literature estimates the prevalence of MBD in the U.S. in a given year to be somewhere between 300,000 and 600,000 cases. Roughly, 56% of breast cancer patients present with MBD at diagnosis and among those who present without metastatic disease, the risk of developing skeletal metastases increases at 5, 10 and 15 years (6.5%, 10.5% and 12% respectively). In addition to breast cancer, a significant portion of patients with advanced prostate, lung, thyroid, renal and bladder carcinoma also have MBD. These numbers, however, likely underestimate MBD, as autopsy studies may suggest that the incidence of bone metastases in patients who die of cancer is close to 70%. Additionally, improved screening methods and advanced treatments have subsequently led to both more accurate detection and improved survival, therefore increasing the incidence of MBD.

• #5 Bone Metastasis Market Size | Growth, Trends & Report 2034

  https://www.imarcgroup.com/bone-metastasis-market

  Bone metastasis occurs in more than 1.5 million cancer patients globally and is most typically associated with malignancies of the prostate, lung, and breast, with an incidence rate of up to 75% of patients with metastatic illness. […] According to the American Cancer Society, around 400,000 new cases of malignant bone metastasis are detected in the United States every year. […] Advanced malignant tumors with bone metastasis have a 30-75 percent incidence, particularly in patients with advanced prostate and breast cancer. […] Prostate cancer had the highest probability of bone metastases (18% to 29%), followed by lung, kidney, and breast cancers. […] In the United States, over 350,000 individuals die each year from bone metastasis. […] IMARC Group’s new report provides an exhaustive analysis of the bone metastasis market in the United States, EU4 (Germany, Spain, Italy, and France), United Kingdom, and Japan. This includes treatment practices, in-market, and pipeline drugs, share of individual therapies, market performance across the seven major markets, market performance of key companies and their drugs, etc.

• #6 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  Bone is the third most common organ affected by metastasis, after the lungs and liver. While skeletal metastases can occur in almost any malignancy, the most common cancers that spread to bone are prostate, breast, lung, kidney and thyroid. Among these malignancies, breast, prostate and lung have the highest incidence in the US, and represent roughly 70% of the cases of metastatic bone disease (MBD) seen by clinicians. Population-based estimates of the prevalence of patients with bone metastases secondary to solid tumors in the US are limited. Nonetheless, recent literature estimates the prevalence of MBD in the U.S. in a given year to be somewhere between 300,000 and 600,000 cases. Roughly, 56% of breast cancer patients present with MBD at diagnosis and among those who present without metastatic disease, the risk of developing skeletal metastases increases at 5, 10 and 15 years (6.5%, 10.5% and 12% respectively). In addition to breast cancer, a significant portion of patients with advanced prostate, lung, thyroid, renal and bladder carcinoma also have MBD. These numbers, however, likely underestimate MBD, as autopsy studies may suggest that the incidence of bone metastases in patients who die of cancer is close to 70%. Additionally, improved screening methods and advanced treatments have subsequently led to both more accurate detection and improved survival, therefore increasing the incidence of MBD.

• #7 Bone metastasis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bone-metastasis/symptoms-causes/syc-20370191

  Bone metastasis occurs when cancer cells spread from their original site to a bone. […] Nearly all types of cancer can spread (metastasize) to the bones. But some types of cancer are particularly likely to spread to bone, including breast cancer and prostate cancer. […] Bone metastasis may be the first sign that you have cancer, or bone metastasis may occur years after cancer treatment. […] Virtually any type of cancer can spread to the bones, but the cancers most likely to cause bone metastasis include: Breast cancer, Kidney cancer, Lung cancer, Lymphoma, Multiple myeloma, Prostate cancer, Thyroid cancer. […] Yu HM, et al. Epidemiology, clinical presentation, and diagnosis, and management of bone metastasis in adults. https://www.uptodate.com/contents/search. Accessed March 1, 2020.

• #8 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  Bone is the third most common organ affected by metastasis, after the lungs and liver. While skeletal metastases can occur in almost any malignancy, the most common cancers that spread to bone are prostate, breast, lung, kidney and thyroid. Among these malignancies, breast, prostate and lung have the highest incidence in the US, and represent roughly 70% of the cases of metastatic bone disease (MBD) seen by clinicians. Population-based estimates of the prevalence of patients with bone metastases secondary to solid tumors in the US are limited. Nonetheless, recent literature estimates the prevalence of MBD in the U.S. in a given year to be somewhere between 300,000 and 600,000 cases. Roughly, 56% of breast cancer patients present with MBD at diagnosis and among those who present without metastatic disease, the risk of developing skeletal metastases increases at 5, 10 and 15 years (6.5%, 10.5% and 12% respectively). In addition to breast cancer, a significant portion of patients with advanced prostate, lung, thyroid, renal and bladder carcinoma also have MBD. These numbers, however, likely underestimate MBD, as autopsy studies may suggest that the incidence of bone metastases in patients who die of cancer is close to 70%. Additionally, improved screening methods and advanced treatments have subsequently led to both more accurate detection and improved survival, therefore increasing the incidence of MBD.

• #9 Bone Metastases – Diagnosis & Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/bone-metastases-diagnosis-treatment/

  The most common site for bone metastases is the vertebra. Although it also occurs in long bones, pelvis, ribs, sternum, and skull. […] Breast, prostate, and lung cancer make up near 80% of bone metastases. […] Bone pain attributed to metastases is the principal source of cancer-related pain and can severely impact quality of life. […] There is wide spread agreement in the studies about what is included in skeletal-related events and how they should be managed. There is little variation between studies in the diagnosis and treatment of bone metastases and their complications. […] Epidemiology, clinical presentation, and diagnosis of bone metastasis in adults Yu M, Hoffe S. 2019 [cited 2019 May 8]. UpToDate [Internet].

• #10 Survival after bone metastasis by primary cancer type: a Danish population-based cohort study | BMJ Open

  https://bmjopen.bmj.com/content/7/9/e016022

  In the 10 most common primary types with bone metastases, we aimed to examine survival, further stratifying on bone metastases only or with additional synchronous metastases. […] We included 17251 patients with bone metastasis. The most common primary cancer types with bone metastasis were prostate (34%), breast (22%) and lung (20%). One-year survival after bone metastasis diagnosis was lowest in patients with lung cancer (10%, 95% CI 9% to 11%) and highest in patients with breast cancer (51%, 50% to 53%). At 5 years of follow-up, only patients with breast cancer had over 10% survival (13%, 11% to 14%). The risk of mortality was increased for the majority of cancer types among patients with bone and synchronous metastases compared with bone only (adjusted relative risk 1.291.57), except for cervix, ovarian and bladder cancer.

• #11 Bone Metastasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507911/

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). Metastases may present with a single bone lesion, oligometastatic disease, multiple bone metastases, or visceral plus bone metastases. A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] The management of a patient with bone metastases requires an interprofessional approach. The therapeutic approach to bone metastases should be an interprofessional approach targeted at preserving the quality of life, including pain control, minimizing SREs, and achieving local tumor control. It is pertinent to consider a multitude of factors including the extent of disease spread, performance status, impending fracture, and side effects when creating the initial approach for the treatment of bone metastases.

• #12 Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study

  https://atm.amegroups.org/article/view/39755/html

  The results of this study provide population-based estimates for the incidence rates of patients with bone metastases at initial diagnosis of their solid tumor. The findings can help clinicians to early detect bone metastases by bone screening to anticipate the occurrence of symptoms and favorably improve the prognosis. […] The incidence of bone metastases among the metastatic subset was 88.74% in prostate cancer, 53.71% in breast cancer, and 38.65% in renal cancer. […] The incidence of bone metastases was higher, and survival time was shorter among patients with more extensive metastases at diagnosis. […] Our results show that cancer presented at diagnosis with bone metastases with the longest median survival time is breast cancer (27 months), followed by prostate cancer (25 months), and thyroid cancer (23 months).

• #13 Incidence and Prevalence of Bone Metastases in Different Solid Tumors Determined by Natural Language Processing of CT Reports

  https://www.mdpi.com/2072-6694/17/2/218

  While many studies have investigated the incidence of bone metastases in different individual cancers, population-based studies on the incidence and prevalence of metastatic bone disease are lacking. […] The utilization of NLP to extract information from routine CT staging scans affords us the ability to better evaluate the temporal development of bone metastases during a patient’s cancer journey. […] The highest incidence and prevalence rates of bone metastases were found in prostate cancer (52%, 32%), followed by breast cancer (41%, 25%). The lowest incidence and prevalence rates were found in central nervous system cancer (8%, 4%) and testicular cancer (5%, 4%).

• #14 Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study

  https://atm.amegroups.org/article/view/39755/html

  The results of this study provide population-based estimates for the incidence rates of patients with bone metastases at initial diagnosis of their solid tumor. The findings can help clinicians to early detect bone metastases by bone screening to anticipate the occurrence of symptoms and favorably improve the prognosis. […] The incidence of bone metastases among the metastatic subset was 88.74% in prostate cancer, 53.71% in breast cancer, and 38.65% in renal cancer. […] The incidence of bone metastases was higher, and survival time was shorter among patients with more extensive metastases at diagnosis. […] Our results show that cancer presented at diagnosis with bone metastases with the longest median survival time is breast cancer (27 months), followed by prostate cancer (25 months), and thyroid cancer (23 months).

• #15 Incidence and Prevalence of Bone Metastases in Different Solid Tumors Determined by Natural Language Processing of CT Reports

  https://www.mdpi.com/2072-6694/17/2/218

  While many studies have investigated the incidence of bone metastases in different individual cancers, population-based studies on the incidence and prevalence of metastatic bone disease are lacking. […] The utilization of NLP to extract information from routine CT staging scans affords us the ability to better evaluate the temporal development of bone metastases during a patient’s cancer journey. […] The highest incidence and prevalence rates of bone metastases were found in prostate cancer (52%, 32%), followed by breast cancer (41%, 25%). The lowest incidence and prevalence rates were found in central nervous system cancer (8%, 4%) and testicular cancer (5%, 4%).

• #16 Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study

  https://atm.amegroups.org/article/view/39755/html

  The results of this study provide population-based estimates for the incidence rates of patients with bone metastases at initial diagnosis of their solid tumor. The findings can help clinicians to early detect bone metastases by bone screening to anticipate the occurrence of symptoms and favorably improve the prognosis. […] The incidence of bone metastases among the metastatic subset was 88.74% in prostate cancer, 53.71% in breast cancer, and 38.65% in renal cancer. […] The incidence of bone metastases was higher, and survival time was shorter among patients with more extensive metastases at diagnosis. […] Our results show that cancer presented at diagnosis with bone metastases with the longest median survival time is breast cancer (27 months), followed by prostate cancer (25 months), and thyroid cancer (23 months).

• #17 Incidence and Prevalence of Bone Metastases in Different Solid Tumors Determined by Natural Language Processing of CT Reports

  https://www.mdpi.com/2072-6694/17/2/218

  Bone metastases significantly impact morbidity and mortality in cancer patients, with varying prognostic implications depending on the primary cancer. Understanding patterns of bone metastases across various primary cancer types is vital, yet comprehensive population-based studies are scarce and challenging to execute. […] Improved survival due to advances in medical therapy has resulted in increasing numbers of cancer patients living with bone metastases; however, our understanding of the prognostic implications of bone metastases requires larger population-based studies outlining their incidence and prevalence in different primary cancer types, including those with lower incidence. […] The accuracy of the NLP model on a validation set was 97.1%, with a positive predictive value (precision) of 88.0% and a sensitivity (recall) of 86.3%. The 5-year incidence rate of bone metastases was highest in prostate, breast, head and neck, and lung cancer (52%, 41%, 36%, 33%). Incidence was lowest in central nervous system cancer and testicular cancer (8%, 5%). Prevalence was highest in prostate, breast, and lung cancer (32%, 25% and 23%), and lowest in central nervous system cancer and testicular cancer (4%, 4%).

• #18 Incidence and Prevalence of Bone Metastases in Different Solid Tumors Determined by Natural Language Processing of CT Reports

  https://www.mdpi.com/2072-6694/17/2/218

  While many studies have investigated the incidence of bone metastases in different individual cancers, population-based studies on the incidence and prevalence of metastatic bone disease are lacking. […] The utilization of NLP to extract information from routine CT staging scans affords us the ability to better evaluate the temporal development of bone metastases during a patient’s cancer journey. […] The highest incidence and prevalence rates of bone metastases were found in prostate cancer (52%, 32%), followed by breast cancer (41%, 25%). The lowest incidence and prevalence rates were found in central nervous system cancer (8%, 4%) and testicular cancer (5%, 4%).

• #19 Incidence and Prevalence of Bone Metastases in Different Solid Tumors Determined by Natural Language Processing of CT Reports

  https://www.mdpi.com/2072-6694/17/2/218

  While many studies have investigated the incidence of bone metastases in different individual cancers, population-based studies on the incidence and prevalence of metastatic bone disease are lacking. […] The utilization of NLP to extract information from routine CT staging scans affords us the ability to better evaluate the temporal development of bone metastases during a patient’s cancer journey. […] The highest incidence and prevalence rates of bone metastases were found in prostate cancer (52%, 32%), followed by breast cancer (41%, 25%). The lowest incidence and prevalence rates were found in central nervous system cancer (8%, 4%) and testicular cancer (5%, 4%).

• #20 Bone Metastasis Market Size | Growth, Trends & Report 2034

  https://www.imarcgroup.com/bone-metastasis-market

  Bone metastasis occurs in more than 1.5 million cancer patients globally and is most typically associated with malignancies of the prostate, lung, and breast, with an incidence rate of up to 75% of patients with metastatic illness. […] According to the American Cancer Society, around 400,000 new cases of malignant bone metastasis are detected in the United States every year. […] Advanced malignant tumors with bone metastasis have a 30-75 percent incidence, particularly in patients with advanced prostate and breast cancer. […] Prostate cancer had the highest probability of bone metastases (18% to 29%), followed by lung, kidney, and breast cancers. […] In the United States, over 350,000 individuals die each year from bone metastasis. […] IMARC Group’s new report provides an exhaustive analysis of the bone metastasis market in the United States, EU4 (Germany, Spain, Italy, and France), United Kingdom, and Japan. This includes treatment practices, in-market, and pipeline drugs, share of individual therapies, market performance across the seven major markets, market performance of key companies and their drugs, etc.

• #21 Bone metastases of unknown origin: epidemiology and principles of management | Journal of Orthopaedics and Traumatology | Full Text

  https://jorthoptraumatol.springeropen.com/articles/10.1007/s10195-015-0344-0

  Thus, detection of bone metastases from occult primaries should raise the suspicion that the lungs are the tissue of origin and the suspicion should be stronger in relatively young patients (60-65 years). After pulmonary origin, bone metastases from undiagnosed renal clear cell carcinomas have increased to 12 %, more than prostate at 10 %, whereas occult thyroid carcinomas are extremely rare (3 %). […] As the spine is the most common site of bone metastases, it is also reported to be the most common site of lesions of unknown origin, followed by the pelvis and long bones; lung and thyroid carcinomas should be strongly suspected at this location. However, spinal malignancy of unknown origin is often derived not only from solid tumors, but also from hematological tumors. […] In conclusion, the epidemiology from analysis of the recent literature justifies firstly considering the lungs as the most probable site of primary carcinoma at the onset of bone metastases of undetected origin. The main goal of histology is to identify those primaries for which curative treatment may be available. Efforts should be made to identify the primary and to provide radical treatment in patients who have only one bone metastasis.

• #22 Bone Metastases – Diagnosis & Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/bone-metastases-diagnosis-treatment/

  The most common site for bone metastases is the vertebra. Although it also occurs in long bones, pelvis, ribs, sternum, and skull. […] Breast, prostate, and lung cancer make up near 80% of bone metastases. […] Bone pain attributed to metastases is the principal source of cancer-related pain and can severely impact quality of life. […] There is wide spread agreement in the studies about what is included in skeletal-related events and how they should be managed. There is little variation between studies in the diagnosis and treatment of bone metastases and their complications. […] Epidemiology, clinical presentation, and diagnosis of bone metastasis in adults Yu M, Hoffe S. 2019 [cited 2019 May 8]. UpToDate [Internet].

• #23 Bone Metastases | Cancer Spread to Bones | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/advanced-cancer/bone-metastases.html

  When cancer cells spread to the bones (bone metastases), they can cause many problems such as pain, broken bones, or more serious problems. Almost all cancers can spread to the bone, but cancers that often spread there include breast, lung, prostate, kidney, melanoma, ovarian, and thyroid. The spine is the most common site for bone metastases. Other common sites are the hip bone (pelvis), upper leg bone (femur), upper arm bone (humerus), ribs, and the skull. […] Finding and treating bone metastases early can help prevent problems later. […] Bone mets may be seen on imaging tests that take pictures of the body. Some common imaging tests used to check for bone mets include: X-ray, CT or CAT scan, MRI, PET scan, Bone scan. […] The drugs used most often for treating bone problems in people with bone metastases are the bisphosphonate drugs pamidronate (Aredia) and zoledronic acid (Zometa) and the drug denosumab (Xgeva). These drugs are given intravenously (IV or into a vein) or subcutaneously (under the skin). Most patients are treated once a month at first, but may be able to be treated less often later on if they are doing well. Treatment with one of these drugs can help prevent further bone damage and events related to weakened bones such as fractures, hypercalcemia, and spinal cord compression.

• #24 Epidemiology and clinic of vertebral metastasis | Revista Española de Cirugía Ortopédica y Traumatología

  https://www.elsevier.es/en-revista-revista-espanola-cirugia-ortopedica-traumatologia-129-articulo-translated-article-epidemiology-clinic-vertebral-S1888441523001753

  Epidemiology and clinic of vertebral metastasis […] In Spain, cancer is the second cause of death in women (22%) and the first in men (31%). Lung, breast, prostate and colon cancer are the most frequent. In most cases, death occurs as a result of metastasis and complications, rather than from the primary tumour. […] The most frequent sites of metastasis are the liver, lung and bone, in that order. Seventy to 80% of malignant tumours will give rise to bone metastases; of these, 70% will be in the spine. […] It is estimated that almost half of patients with spinal metastases will have metastases at multiple levels of the spine. […] In 2013, we conducted a review of 279 cases of metastases treated at our centre between 2006 and 2010. […] The most frequent primaries were: lung 26.1% (n=73), breast 21.8% (n=61) and prostate 10.7% (n=30).

• #25 Epidemiology and clinic of vertebral metastasis | Revista Española de Cirugía Ortopédica y Traumatología

  https://www.elsevier.es/en-revista-revista-espanola-cirugia-ortopedica-traumatologia-129-articulo-translated-article-epidemiology-clinic-vertebral-S1888441523001753

  Epidemiology and clinic of vertebral metastasis […] In Spain, cancer is the second cause of death in women (22%) and the first in men (31%). Lung, breast, prostate and colon cancer are the most frequent. In most cases, death occurs as a result of metastasis and complications, rather than from the primary tumour. […] The most frequent sites of metastasis are the liver, lung and bone, in that order. Seventy to 80% of malignant tumours will give rise to bone metastases; of these, 70% will be in the spine. […] It is estimated that almost half of patients with spinal metastases will have metastases at multiple levels of the spine. […] In 2013, we conducted a review of 279 cases of metastases treated at our centre between 2006 and 2010. […] The most frequent primaries were: lung 26.1% (n=73), breast 21.8% (n=61) and prostate 10.7% (n=30).

• #26 Bone metastases of unknown origin: epidemiology and principles of management | Journal of Orthopaedics and Traumatology | Full Text

  https://jorthoptraumatol.springeropen.com/articles/10.1007/s10195-015-0344-0

  Thus, detection of bone metastases from occult primaries should raise the suspicion that the lungs are the tissue of origin and the suspicion should be stronger in relatively young patients (60-65 years). After pulmonary origin, bone metastases from undiagnosed renal clear cell carcinomas have increased to 12 %, more than prostate at 10 %, whereas occult thyroid carcinomas are extremely rare (3 %). […] As the spine is the most common site of bone metastases, it is also reported to be the most common site of lesions of unknown origin, followed by the pelvis and long bones; lung and thyroid carcinomas should be strongly suspected at this location. However, spinal malignancy of unknown origin is often derived not only from solid tumors, but also from hematological tumors. […] In conclusion, the epidemiology from analysis of the recent literature justifies firstly considering the lungs as the most probable site of primary carcinoma at the onset of bone metastases of undetected origin. The main goal of histology is to identify those primaries for which curative treatment may be available. Efforts should be made to identify the primary and to provide radical treatment in patients who have only one bone metastasis.

• #27 Bone metastases of unknown origin: epidemiology and principles of management | Journal of Orthopaedics and Traumatology | Full Text

  https://jorthoptraumatol.springeropen.com/articles/10.1007/s10195-015-0344-0

  Thus, detection of bone metastases from occult primaries should raise the suspicion that the lungs are the tissue of origin and the suspicion should be stronger in relatively young patients (60-65 years). After pulmonary origin, bone metastases from undiagnosed renal clear cell carcinomas have increased to 12 %, more than prostate at 10 %, whereas occult thyroid carcinomas are extremely rare (3 %). […] As the spine is the most common site of bone metastases, it is also reported to be the most common site of lesions of unknown origin, followed by the pelvis and long bones; lung and thyroid carcinomas should be strongly suspected at this location. However, spinal malignancy of unknown origin is often derived not only from solid tumors, but also from hematological tumors. […] In conclusion, the epidemiology from analysis of the recent literature justifies firstly considering the lungs as the most probable site of primary carcinoma at the onset of bone metastases of undetected origin. The main goal of histology is to identify those primaries for which curative treatment may be available. Efforts should be made to identify the primary and to provide radical treatment in patients who have only one bone metastasis.

• #28 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  This study aimed at establishing more accurate predictive models based on novel machine learning algorithms, with the overarching goal of providing clinicians with effective decision-making assistance. […] We retrospectively analyzed the breast cancer patients recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. […] Univariable and multivariable logistic regression analyses showed that bone metastases were significantly associated with age, race, sex, grade, T stage, N stage, surgery, radiotherapy, chemotherapy, tumor size, brain metastasis, liver metastasis, lung metastasis, breast subtype, and PR. […] Univariate and multivariate Cox regression analyses revealed that age, race, marital status, grade, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, lung metastasis, breast subtype, ER, and PR were closely associated with the prognosis of BCBM.

• #29 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  This study aimed at establishing more accurate predictive models based on novel machine learning algorithms, with the overarching goal of providing clinicians with effective decision-making assistance. […] We retrospectively analyzed the breast cancer patients recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. […] Univariable and multivariable logistic regression analyses showed that bone metastases were significantly associated with age, race, sex, grade, T stage, N stage, surgery, radiotherapy, chemotherapy, tumor size, brain metastasis, liver metastasis, lung metastasis, breast subtype, and PR. […] Univariate and multivariate Cox regression analyses revealed that age, race, marital status, grade, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, lung metastasis, breast subtype, ER, and PR were closely associated with the prognosis of BCBM.

• #30 Metastatic Bone Disease: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/1253331-overview

  Approximately 1.8 million patients present with cancer each year in the United States. Of these, substantial percentages (varying by primary tumor) have metastases to bone. In contrast, approximately 4000 patients per year develop primary bone or joint cancer. […] The age range of patients with sarcoma is different from that of individuals with carcinoma of bone; most metastatic bone lesions occur in adults older than 50 years, whereas most sarcomas occur in adolescents or young adults (30 y). Therefore, a bone-occupying mass in an adult is much more likely to be a focus of metastatic carcinoma than to be a primary sarcoma of bone. Nevertheless, in a patient with a bone lesion with no documentation of metastatic disease, caution is warranted to ensure the correct diagnosis. […] In an analysis focusing on the five most common primary sources of metastatic bone disease (ie, lung, prostate, breast, kidney, and colon), Jawad et al found that non-Hispanic Blacks had a higher incidence of metastatic bone disease for primary prostate and breast cancers, whereas non-Hispanic American Indians and Alaskan Natives had a higher incidence of primary renal and colon cancers. In addition, the incidence of metastatic bone disease was higher in groups with lower socioeconomic status, possibly as a consequence of delayed diagnosis and limited access to screening modalities.

• #31 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  This study aimed at establishing more accurate predictive models based on novel machine learning algorithms, with the overarching goal of providing clinicians with effective decision-making assistance. […] We retrospectively analyzed the breast cancer patients recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. […] Univariable and multivariable logistic regression analyses showed that bone metastases were significantly associated with age, race, sex, grade, T stage, N stage, surgery, radiotherapy, chemotherapy, tumor size, brain metastasis, liver metastasis, lung metastasis, breast subtype, and PR. […] Univariate and multivariate Cox regression analyses revealed that age, race, marital status, grade, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, lung metastasis, breast subtype, ER, and PR were closely associated with the prognosis of BCBM.

• #32 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  This study aimed at establishing more accurate predictive models based on novel machine learning algorithms, with the overarching goal of providing clinicians with effective decision-making assistance. […] We retrospectively analyzed the breast cancer patients recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. […] Univariable and multivariable logistic regression analyses showed that bone metastases were significantly associated with age, race, sex, grade, T stage, N stage, surgery, radiotherapy, chemotherapy, tumor size, brain metastasis, liver metastasis, lung metastasis, breast subtype, and PR. […] Univariate and multivariate Cox regression analyses revealed that age, race, marital status, grade, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, lung metastasis, breast subtype, ER, and PR were closely associated with the prognosis of BCBM.

• #33 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  Given the complexity of metastatic BC therapies, the treatment of BC with bone metastasis (BCBM) is limited to cytotoxic chemotherapies, endocrine therapies, and targeted therapies. […] Therefore, it is crucial to identify patients who may have bone metastasis and predict their survival rate. […] This study found that BC patients who did not undergo surgery were at high risk of developing BM. […] We also found that T stage and N stage were strong predictors of BM. […] Interestingly, surgery was also the most critical feature of prognostic model, followed by liver metastasis. […] The ultimate purpose of building models is to be more convenient for clinical application and help clinicians make decisions.

• #34 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  This study aimed at establishing more accurate predictive models based on novel machine learning algorithms, with the overarching goal of providing clinicians with effective decision-making assistance. […] We retrospectively analyzed the breast cancer patients recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. […] Univariable and multivariable logistic regression analyses showed that bone metastases were significantly associated with age, race, sex, grade, T stage, N stage, surgery, radiotherapy, chemotherapy, tumor size, brain metastasis, liver metastasis, lung metastasis, breast subtype, and PR. […] Univariate and multivariate Cox regression analyses revealed that age, race, marital status, grade, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, lung metastasis, breast subtype, ER, and PR were closely associated with the prognosis of BCBM.

• #35 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  This study aimed at establishing more accurate predictive models based on novel machine learning algorithms, with the overarching goal of providing clinicians with effective decision-making assistance. […] We retrospectively analyzed the breast cancer patients recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. […] Univariable and multivariable logistic regression analyses showed that bone metastases were significantly associated with age, race, sex, grade, T stage, N stage, surgery, radiotherapy, chemotherapy, tumor size, brain metastasis, liver metastasis, lung metastasis, breast subtype, and PR. […] Univariate and multivariate Cox regression analyses revealed that age, race, marital status, grade, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, lung metastasis, breast subtype, ER, and PR were closely associated with the prognosis of BCBM.

• #36 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  This study aimed at establishing more accurate predictive models based on novel machine learning algorithms, with the overarching goal of providing clinicians with effective decision-making assistance. […] We retrospectively analyzed the breast cancer patients recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. […] Univariable and multivariable logistic regression analyses showed that bone metastases were significantly associated with age, race, sex, grade, T stage, N stage, surgery, radiotherapy, chemotherapy, tumor size, brain metastasis, liver metastasis, lung metastasis, breast subtype, and PR. […] Univariate and multivariate Cox regression analyses revealed that age, race, marital status, grade, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, lung metastasis, breast subtype, ER, and PR were closely associated with the prognosis of BCBM.

• #37 Predicting diagnosis and survival of bone metastasis in breast cancer using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-023-45438-z

  Given the complexity of metastatic BC therapies, the treatment of BC with bone metastasis (BCBM) is limited to cytotoxic chemotherapies, endocrine therapies, and targeted therapies. […] Therefore, it is crucial to identify patients who may have bone metastasis and predict their survival rate. […] This study found that BC patients who did not undergo surgery were at high risk of developing BM. […] We also found that T stage and N stage were strong predictors of BM. […] Interestingly, surgery was also the most critical feature of prognostic model, followed by liver metastasis. […] The ultimate purpose of building models is to be more convenient for clinical application and help clinicians make decisions.

• #38 Metastatic Bone Disease: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/1253331-overview

  Approximately 1.8 million patients present with cancer each year in the United States. Of these, substantial percentages (varying by primary tumor) have metastases to bone. In contrast, approximately 4000 patients per year develop primary bone or joint cancer. […] The age range of patients with sarcoma is different from that of individuals with carcinoma of bone; most metastatic bone lesions occur in adults older than 50 years, whereas most sarcomas occur in adolescents or young adults (30 y). Therefore, a bone-occupying mass in an adult is much more likely to be a focus of metastatic carcinoma than to be a primary sarcoma of bone. Nevertheless, in a patient with a bone lesion with no documentation of metastatic disease, caution is warranted to ensure the correct diagnosis. […] In an analysis focusing on the five most common primary sources of metastatic bone disease (ie, lung, prostate, breast, kidney, and colon), Jawad et al found that non-Hispanic Blacks had a higher incidence of metastatic bone disease for primary prostate and breast cancers, whereas non-Hispanic American Indians and Alaskan Natives had a higher incidence of primary renal and colon cancers. In addition, the incidence of metastatic bone disease was higher in groups with lower socioeconomic status, possibly as a consequence of delayed diagnosis and limited access to screening modalities.

• #39 A Surveillance, Epidemiology and End Results database analysis of the prognostic value of organ‑specific metastases in patients with advanced prostatic adenocarcinoma

  https://www.spandidos-publications.com/10.3892/ol.2019.10461

  Several variates were identified by univariate and multivariate analysis of cancer specific-survival (CSS) and overall survival (OS) in PCa patients using Cox hazards regression models. […] Single/unmarried status, age 50 years, black race, M1 stage, bone metastasis, liver metastasis and lung metastasis were associated with worse CSS and OS. […] The 3-year CSS rate of patients who received prostatectomy was 97.3%, compared with 54.3% in patients who did not undergo prostatectomy. […] The current study also revealed that patients with grade IV PCa (undifferentiated) had a higher risk of bone metastases than grade I patients. […] The findings of the current study also suggested that black patients with stage IV PCa had worse CSS and OS compared with white patients. […] The current findings demonstrate that, for patients with bone metastasis, prostatectomy may significantly improve both CSS and OS.

• #40 Bone Metastasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507911/

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). Metastases may present with a single bone lesion, oligometastatic disease, multiple bone metastases, or visceral plus bone metastases. A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] The management of a patient with bone metastases requires an interprofessional approach. The therapeutic approach to bone metastases should be an interprofessional approach targeted at preserving the quality of life, including pain control, minimizing SREs, and achieving local tumor control. It is pertinent to consider a multitude of factors including the extent of disease spread, performance status, impending fracture, and side effects when creating the initial approach for the treatment of bone metastases.

• #41 Incidence of bone metastases in patients with solid tumors: analysis of oncology electronic medical records in the United States | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-017-3922-0

  The current study was conducted to estimate the incidence of bone metastases reflecting the more recent treatment landscape for patients with solid tumors. Specifically, we estimated the cumulative incidence proportion of clinically-identified bone metastases for all solid tumors combined and by tumor type using electronic medical records (EMR) data from oncology clinics in the United States (US). Results are presented for various time intervals during up to ten years of follow-up. […] The cumulative incidence of bone metastasis increased by stage at diagnosis, with markedly higher incidence among patients diagnosed at Stage IV of whom 11% had bone metastases diagnosed within 30 days. […] This study estimated the cumulative incidence of bone metastasis among patients with solid tumors using real world electronic medical record data from oncology practices in the US. To our knowledge, this is the first large-scale US study to estimate the incidence of bone metastases for all solid tumors combined and by tumor type, with patients followed for up to 10 years after their initial solid tumor diagnosis. Cumulative incidence increased from 2.9% within 30 days of the first solid tumor diagnosis in the study period to 8.4% during a ten year follow-up period.

• #42 Bone Metastasis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18450

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). […] A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] It is pertinent to identify bone metastasis early, both for staging and prognostication as well as the implementation of prophylactic and treatment strategies which may lead to decreased morbidity and mortality.

• #43 Incidence of bone metastases in patients with solid tumors: analysis of oncology electronic medical records in the United States | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-017-3922-0

  The current study was conducted to estimate the incidence of bone metastases reflecting the more recent treatment landscape for patients with solid tumors. Specifically, we estimated the cumulative incidence proportion of clinically-identified bone metastases for all solid tumors combined and by tumor type using electronic medical records (EMR) data from oncology clinics in the United States (US). Results are presented for various time intervals during up to ten years of follow-up. […] The cumulative incidence of bone metastasis increased by stage at diagnosis, with markedly higher incidence among patients diagnosed at Stage IV of whom 11% had bone metastases diagnosed within 30 days. […] This study estimated the cumulative incidence of bone metastasis among patients with solid tumors using real world electronic medical record data from oncology practices in the US. To our knowledge, this is the first large-scale US study to estimate the incidence of bone metastases for all solid tumors combined and by tumor type, with patients followed for up to 10 years after their initial solid tumor diagnosis. Cumulative incidence increased from 2.9% within 30 days of the first solid tumor diagnosis in the study period to 8.4% during a ten year follow-up period.

• #44 Incidence of bone metastases in patients with solid tumors: analysis of oncology electronic medical records in the United States | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-017-3922-0

  Not surprisingly, we found that the incidence of bone metastasis was higher among patients with more advanced disease (i.e., higher stage) at diagnosis in the solid tumor population overall and for the individual tumor types that we examined. This pattern continued over time; we noted this relationship between stage at diagnosis and bone metastasis incidence in every follow-up interval for the study population overall and for each tumor type. […] Development of bone metastases is an important prognostic indicator, with population-based studies demonstrating a significantly shorter survival after bone metastases occur. […] Since 1996, three agents have been marketed in the US for the prevention of SREs in patients with bone metastasis secondary to solid tumors. With effective treatment options available and evidence regarding the significant mortality and morbidity implications of bone metastasis and SREs accumulating in the medical literature, bone health is increasingly addressed in key clinical guidelines.

• #45 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  Bone is the third most common organ affected by metastasis, after the lungs and liver. While skeletal metastases can occur in almost any malignancy, the most common cancers that spread to bone are prostate, breast, lung, kidney and thyroid. Among these malignancies, breast, prostate and lung have the highest incidence in the US, and represent roughly 70% of the cases of metastatic bone disease (MBD) seen by clinicians. Population-based estimates of the prevalence of patients with bone metastases secondary to solid tumors in the US are limited. Nonetheless, recent literature estimates the prevalence of MBD in the U.S. in a given year to be somewhere between 300,000 and 600,000 cases. Roughly, 56% of breast cancer patients present with MBD at diagnosis and among those who present without metastatic disease, the risk of developing skeletal metastases increases at 5, 10 and 15 years (6.5%, 10.5% and 12% respectively). In addition to breast cancer, a significant portion of patients with advanced prostate, lung, thyroid, renal and bladder carcinoma also have MBD. These numbers, however, likely underestimate MBD, as autopsy studies may suggest that the incidence of bone metastases in patients who die of cancer is close to 70%. Additionally, improved screening methods and advanced treatments have subsequently led to both more accurate detection and improved survival, therefore increasing the incidence of MBD.

• #46 Bone Metastatic Breast Cancer: Advances in Cell Signaling and Autophagy Related Mechanisms

  https://www.mdpi.com/2072-6694/13/17/4310

  Bone metastasis is a leading cause of breast cancer-related deaths. The interaction between metastatic cancer cells and bone-resident cells promotes tumor growth and bone loss. Metastatic tumors within the bone can contribute to complications including pathological fracture, hypercalcemia, spinal cord compression, and pain. The underlying molecular mechanisms that regulate these interactions in the bone microenvironment are not completely understood. […] Bone metastasis is a frequent complication of breast cancer with nearly 70% of metastatic breast cancer patients developing bone metastasis during the course of their disease. The overall incidence of MBD is rising, from 18.00 to 19.06 per 100,000 from 2010 to 2015 in a SEER study. […] It has been estimated that approximately 70 percent of patients with metastatic breast cancer will develop bone metastasis, with approximately 5–8 percent of patients exhibiting metastatic tumors at the time of diagnosis.

• #47 Bone metastases of unknown origin: epidemiology and principles of management | Journal of Orthopaedics and Traumatology | Full Text

  https://jorthoptraumatol.springeropen.com/articles/10.1007/s10195-015-0344-0

  Metastasis of unknown primary origin is reported to occur in 34 % of all cancer patients and 10-15 % of them present with skeletal localizations. The bone is the third most common site of metastatic cancer of unknown primary origin, after the lymph nodes and the lung. Lung, liver, pancreas and gastrointestinal tract are common sites of primary occult tumors. Adenocarcinoma is the main histological type, accounting for 70 % of all cases, while undifferentiated cancer accounts for 15 % and squamous cell carcinomas 10 %. Occult carcinomas are clinically different from their respective manifest forms: with regard to skeletal involvement, the incidence of bone metastases from pulmonary carcinoma is much lower if the primary is occult (4 %) than if it is known (30-50 %); similarly, bone lesions from occult prostate cancer are three times less common than from a known primary, whereas they are four times more common in cases of occult pancreatic primary. Some unknown primary tumors are treatable, like lymphoma, extragonal germ cell neoplasms and ovarian cancer, but the majority of cases have a short fatal clinical course with very scarce possibilities of employing effective chemotherapy.

• #48 Bone metastases of unknown origin: epidemiology and principles of management | Journal of Orthopaedics and Traumatology | Full Text

  https://jorthoptraumatol.springeropen.com/articles/10.1007/s10195-015-0344-0

  Metastasis of unknown primary origin is reported to occur in 34 % of all cancer patients and 10-15 % of them present with skeletal localizations. The bone is the third most common site of metastatic cancer of unknown primary origin, after the lymph nodes and the lung. Lung, liver, pancreas and gastrointestinal tract are common sites of primary occult tumors. Adenocarcinoma is the main histological type, accounting for 70 % of all cases, while undifferentiated cancer accounts for 15 % and squamous cell carcinomas 10 %. Occult carcinomas are clinically different from their respective manifest forms: with regard to skeletal involvement, the incidence of bone metastases from pulmonary carcinoma is much lower if the primary is occult (4 %) than if it is known (30-50 %); similarly, bone lesions from occult prostate cancer are three times less common than from a known primary, whereas they are four times more common in cases of occult pancreatic primary. Some unknown primary tumors are treatable, like lymphoma, extragonal germ cell neoplasms and ovarian cancer, but the majority of cases have a short fatal clinical course with very scarce possibilities of employing effective chemotherapy.

• #49 diagnostic approach to bone metastasis of unknown origin: a systematic review | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/123441-diagnostic-approach-to-bone-metastasis-of-unknown-origin-a-systematic-review

  Among all MBD cases, 3% have an unidentified origin and are commonly misdiagnosed. On average, nearly 75% of MBD cases with an unknown origin take four months to diagnose. This difficulty in identifying the primary cancer limits the treatment of skeletal metastases to palliative measures, negatively impacting a patients prognosis. […] The overall survival rate of MBD patients is approximately 5% five years after diagnosis, and this number drops to 1% after ten years, with a median survival of 5 months post-diagnosis. Diagnostic delay has been identified as a significant factor contributing to unfavorable patient outcomes, combined with the overall burden imposed by the unknown primary lesion of MBD. […] Biopsy is crucial in identifying the primary lesion of metastatic bone disease with an unknown origin, with a detection rate of 38.2%, making it the most frequently recommended examination.

• #50 diagnostic approach to bone metastasis of unknown origin: a systematic review | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/123441-diagnostic-approach-to-bone-metastasis-of-unknown-origin-a-systematic-review

  Among all MBD cases, 3% have an unidentified origin and are commonly misdiagnosed. On average, nearly 75% of MBD cases with an unknown origin take four months to diagnose. This difficulty in identifying the primary cancer limits the treatment of skeletal metastases to palliative measures, negatively impacting a patients prognosis. […] The overall survival rate of MBD patients is approximately 5% five years after diagnosis, and this number drops to 1% after ten years, with a median survival of 5 months post-diagnosis. Diagnostic delay has been identified as a significant factor contributing to unfavorable patient outcomes, combined with the overall burden imposed by the unknown primary lesion of MBD. […] Biopsy is crucial in identifying the primary lesion of metastatic bone disease with an unknown origin, with a detection rate of 38.2%, making it the most frequently recommended examination.

• #51

  https://www.orthobullets.com/evidence/25726410

  Metastases are the most common malignancies involving bone; breast, prostate, lung and thyroid are the main sites of primary cancer. However, up to 30 % of patients present with bone metastases of unknown origin, where the site of the primary neoplasm cannot be identified at the time of diagnosis despite a thorough history, physical examination, appropriate laboratory testing and modern imaging technology (CT, MRI, PET). […] The authors reviewed the relevant literature in an attempt to investigate the epidemiology of the histological primaries finally identified in patients with bone metastases from occult cancer, and a strategy of management and treatment of bone metastases from occult carcinomas is suggested. […] Over the past 30 years, lung cancer is the main causative occult primary for bone metastases and has a poor prognosis with an average survival of 4-8 months.

• #52 Bone metastases of unknown origin: epidemiology and principles of management | Journal of Orthopaedics and Traumatology | Full Text

  https://jorthoptraumatol.springeropen.com/articles/10.1007/s10195-015-0344-0

  Thus, detection of bone metastases from occult primaries should raise the suspicion that the lungs are the tissue of origin and the suspicion should be stronger in relatively young patients (60-65 years). After pulmonary origin, bone metastases from undiagnosed renal clear cell carcinomas have increased to 12 %, more than prostate at 10 %, whereas occult thyroid carcinomas are extremely rare (3 %). […] As the spine is the most common site of bone metastases, it is also reported to be the most common site of lesions of unknown origin, followed by the pelvis and long bones; lung and thyroid carcinomas should be strongly suspected at this location. However, spinal malignancy of unknown origin is often derived not only from solid tumors, but also from hematological tumors. […] In conclusion, the epidemiology from analysis of the recent literature justifies firstly considering the lungs as the most probable site of primary carcinoma at the onset of bone metastases of undetected origin. The main goal of histology is to identify those primaries for which curative treatment may be available. Efforts should be made to identify the primary and to provide radical treatment in patients who have only one bone metastasis.

• #53 Bone Metastases: Epidemiology and Societal Effect | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-52001-3_1

  The incidence of skeletal metastases is increasing as survival from cancer increases. […] Special attention is given to socioeconomic factors that may lead to healthcare disparities among patients with metastatic bone disease. […] Further, the incidences of skeletal-related events (SREs) and pathological fracture are reviewed from epidemiological data and the placebo wings of randomized trials of bisphosphonate therapy in metastatic bone disease. […] The economic and social burden of SREs in metastatic bone disease to health organizations, both patients and caregivers, and the wider economy are reviewed.

• #54 Bone Metastases: Epidemiology and Societal Effect | SpringerLink

  https://link.springer.com/chapter/10.1007/978-1-4614-5662-9_1

  The incidence of skeletal metastases is increasing as survival from cancer increases. […] This introductory chapter looks at the epidemiology of metastatic bone disease and the impact of increasing survival of patients with cancer. […] The incidence of skeletal related events (SREs) and pathological fracture are reviewed from epidemiological data and the placebo wings of randomized trials of bisphosphonate therapy in metastatic bone disease. […] The economic and social burden of SREs in metastatic bone disease to health organizations, both patients and caregivers, and the wider economy are reviewed and updated to 2014 costs.

• #55 Bone Metastatic Breast Cancer: Advances in Cell Signaling and Autophagy Related Mechanisms

  https://www.mdpi.com/2072-6694/13/17/4310

  Bone metastasis is a leading cause of breast cancer-related deaths. The interaction between metastatic cancer cells and bone-resident cells promotes tumor growth and bone loss. Metastatic tumors within the bone can contribute to complications including pathological fracture, hypercalcemia, spinal cord compression, and pain. The underlying molecular mechanisms that regulate these interactions in the bone microenvironment are not completely understood. […] Bone metastasis is a frequent complication of breast cancer with nearly 70% of metastatic breast cancer patients developing bone metastasis during the course of their disease. The overall incidence of MBD is rising, from 18.00 to 19.06 per 100,000 from 2010 to 2015 in a SEER study. […] It has been estimated that approximately 70 percent of patients with metastatic breast cancer will develop bone metastasis, with approximately 5–8 percent of patients exhibiting metastatic tumors at the time of diagnosis.

• #56 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  Bone is the third most common organ affected by metastasis, after the lungs and liver. While skeletal metastases can occur in almost any malignancy, the most common cancers that spread to bone are prostate, breast, lung, kidney and thyroid. Among these malignancies, breast, prostate and lung have the highest incidence in the US, and represent roughly 70% of the cases of metastatic bone disease (MBD) seen by clinicians. Population-based estimates of the prevalence of patients with bone metastases secondary to solid tumors in the US are limited. Nonetheless, recent literature estimates the prevalence of MBD in the U.S. in a given year to be somewhere between 300,000 and 600,000 cases. Roughly, 56% of breast cancer patients present with MBD at diagnosis and among those who present without metastatic disease, the risk of developing skeletal metastases increases at 5, 10 and 15 years (6.5%, 10.5% and 12% respectively). In addition to breast cancer, a significant portion of patients with advanced prostate, lung, thyroid, renal and bladder carcinoma also have MBD. These numbers, however, likely underestimate MBD, as autopsy studies may suggest that the incidence of bone metastases in patients who die of cancer is close to 70%. Additionally, improved screening methods and advanced treatments have subsequently led to both more accurate detection and improved survival, therefore increasing the incidence of MBD.

• #57 Incidence and Prevalence of Bone Metastases in Different Solid Tumors Determined by Natural Language Processing of CT Reports

  https://www.mdpi.com/2072-6694/17/2/218

  Bone metastases significantly impact morbidity and mortality in cancer patients, with varying prognostic implications depending on the primary cancer. Understanding patterns of bone metastases across various primary cancer types is vital, yet comprehensive population-based studies are scarce and challenging to execute. […] Improved survival due to advances in medical therapy has resulted in increasing numbers of cancer patients living with bone metastases; however, our understanding of the prognostic implications of bone metastases requires larger population-based studies outlining their incidence and prevalence in different primary cancer types, including those with lower incidence. […] The accuracy of the NLP model on a validation set was 97.1%, with a positive predictive value (precision) of 88.0% and a sensitivity (recall) of 86.3%. The 5-year incidence rate of bone metastases was highest in prostate, breast, head and neck, and lung cancer (52%, 41%, 36%, 33%). Incidence was lowest in central nervous system cancer and testicular cancer (8%, 5%). Prevalence was highest in prostate, breast, and lung cancer (32%, 25% and 23%), and lowest in central nervous system cancer and testicular cancer (4%, 4%).

• #58 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  Bone is the third most common organ affected by metastasis, after the lungs and liver. While skeletal metastases can occur in almost any malignancy, the most common cancers that spread to bone are prostate, breast, lung, kidney and thyroid. Among these malignancies, breast, prostate and lung have the highest incidence in the US, and represent roughly 70% of the cases of metastatic bone disease (MBD) seen by clinicians. Population-based estimates of the prevalence of patients with bone metastases secondary to solid tumors in the US are limited. Nonetheless, recent literature estimates the prevalence of MBD in the U.S. in a given year to be somewhere between 300,000 and 600,000 cases. Roughly, 56% of breast cancer patients present with MBD at diagnosis and among those who present without metastatic disease, the risk of developing skeletal metastases increases at 5, 10 and 15 years (6.5%, 10.5% and 12% respectively). In addition to breast cancer, a significant portion of patients with advanced prostate, lung, thyroid, renal and bladder carcinoma also have MBD. These numbers, however, likely underestimate MBD, as autopsy studies may suggest that the incidence of bone metastases in patients who die of cancer is close to 70%. Additionally, improved screening methods and advanced treatments have subsequently led to both more accurate detection and improved survival, therefore increasing the incidence of MBD.

• #59 Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study

  https://atm.amegroups.org/article/view/39755/html

  The early detection of bone metastases may minimize morbidity and mortality and lead to a better quality of life, while also being a fundamental step in anticancer treatment. […] Our data show a relatively high rate of bone metastasis in these populations—one which may be underestimated. Therefore, our findings may support the need to routinely screen for bone metastases at diagnosis for these patients.

• #60 Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/7/393

  Unfortunately, most patients have already sustained a pathologic fracture by the time they present to an orthopedic team and thus have a greater likelihood of severe discomfort and increased morbidity during the treatment process. […] Heightened awareness in the primary care setting of possible metastatic bone disease is essential in patients who present with musculoskeletal pain and a history of cancer or previous radiotherapy. […] The management of patients with skeletal events due to bone metastasis has important implications for healthcare costs. Early intervention for patients with metastatic bone disease has been shown to reduce patient morbidity as well as overall cost. […] A prompt, proactive response has been shown to reduce complication rates, length of stay, need for community care, and overall treatment costs, and this is specifically true of pathologic fracture. […] A prophylactic approach has shown to be safer and much more cost-effective compared with traditional management, or acute fixation, after a completed fracture. […] The appropriate surgical approach and choice of implant have the potential to reduce healthcare costs.

• #61 Predictive and prognostic biomarkers of bone metastasis in breast cancer: current status and future directions | Cell & Bioscience | Full Text

  https://cellandbioscience.biomedcentral.com/articles/10.1186/s13578-023-01171-8

  Considering the profound consequences of bone metastasis and the potential for late recurrence, early detection of bone metastasis and identification of patients at elevated risk of bone metastasis are of utmost importance. Improved screening with biomarkers creates opportunities to provide personalized strategies for early prevention, diagnosis, and treatment. […] Here, we summarize the epidemiology of BCBM and the current approaches to diagnosis and treatment. […] Diagnostic guidelines for BCBM recommend timely imaging evaluation and biopsy in cases of suspected bone metastasis based on symptoms such as bone pain, pathological fractures, elevated alkaline phosphatase levels, or hypercalcemia. […] Detecting bone metastasis early and preventing bone metastasis in high-risk populations can improve the timeliness of treatment and therefore quality of life and prognosis of breast cancer patients.

• #62 Predictive and prognostic biomarkers of bone metastasis in breast cancer: current status and future directions | Cell & Bioscience | Full Text

  https://cellandbioscience.biomedcentral.com/articles/10.1186/s13578-023-01171-8

  Considering the profound consequences of bone metastasis and the potential for late recurrence, early detection of bone metastasis and identification of patients at elevated risk of bone metastasis are of utmost importance. Improved screening with biomarkers creates opportunities to provide personalized strategies for early prevention, diagnosis, and treatment. […] Here, we summarize the epidemiology of BCBM and the current approaches to diagnosis and treatment. […] Diagnostic guidelines for BCBM recommend timely imaging evaluation and biopsy in cases of suspected bone metastasis based on symptoms such as bone pain, pathological fractures, elevated alkaline phosphatase levels, or hypercalcemia. […] Detecting bone metastasis early and preventing bone metastasis in high-risk populations can improve the timeliness of treatment and therefore quality of life and prognosis of breast cancer patients.

• #63 Metastatic bone disease – epidemiology, characteristic…

  https://polishorthopaedics.pl/seo/article/545215/en

  Metastatic bone disease (MBD) is a common problem among patients with malignant tumors. Bone tissue is the third most frequent site of metastasis, following the lungs and liver. The risk of bone metastases increases with the duration of the cancer disease. Early diagnosis should be implemented when a patient with malignant tumors reports symptoms such as bone pain, joint mobility disorders, or neurological symptoms. Attention should also be drawn to abnormalities in laboratory tests – elevated calcium levels in serum (hypercalcemia). In the case of fractures in atypical locations or occurring after low-energy trauma, oncological disease should be included in the differential diagnosis. The first-line imaging studies include X-rays and computed tomography. Magnetic resonance imaging is recommended in cases of diagnostic uncertainty or changes in the axial skeleton. Additionally, scintigraphy allows for determining the nature of the lesion and oncological staging (assessment of the number of metastatic lesions to the bones). Hybrid studies are also used, characterized by the best sensitivity and specificity parameters. If dealing with a tumor of unknown origin, the most important diagnostic step is biopsy, which should be performed by an experienced clinician at a bone cancer treatment center. The authors of the publication hope that the review presented below will help expand knowledge about MBD, optimize its diagnostic process, and improve medical care in Poland for patients with metastatic bone disease.

• #64 Bone Metastases | Cancer Spread to Bones | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/advanced-cancer/bone-metastases.html

  When cancer cells spread to the bones (bone metastases), they can cause many problems such as pain, broken bones, or more serious problems. Almost all cancers can spread to the bone, but cancers that often spread there include breast, lung, prostate, kidney, melanoma, ovarian, and thyroid. The spine is the most common site for bone metastases. Other common sites are the hip bone (pelvis), upper leg bone (femur), upper arm bone (humerus), ribs, and the skull. […] Finding and treating bone metastases early can help prevent problems later. […] Bone mets may be seen on imaging tests that take pictures of the body. Some common imaging tests used to check for bone mets include: X-ray, CT or CAT scan, MRI, PET scan, Bone scan. […] The drugs used most often for treating bone problems in people with bone metastases are the bisphosphonate drugs pamidronate (Aredia) and zoledronic acid (Zometa) and the drug denosumab (Xgeva). These drugs are given intravenously (IV or into a vein) or subcutaneously (under the skin). Most patients are treated once a month at first, but may be able to be treated less often later on if they are doing well. Treatment with one of these drugs can help prevent further bone damage and events related to weakened bones such as fractures, hypercalcemia, and spinal cord compression.

• #65 Pathology & Oncology Research | Management and surveillance of metastatic giant cell tumour of bone

  https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2025.1611916/full

  Giant cell tumour of bone (GCTB) is viewed as a benign, locally aggressive primary bone tumour with metastatic potential. […] This study aimed to assess incidence, surveillance and management of PM in patients with GCTB, with histopathological review. […] Pulmonary metastases were identified in 11 patients. […] This left 8 (9.6%) patients, one had PM at presentation and seven at follow-up between 2 and 42 months. […] GCTB may present with PM, but more commonly, metastasis occurs after surgery, presenting on surveillance and can progress. […] PM can behave aggressively, necessitating identifying histological markers to recognise patients at risk of metastatic GCTB, for example, through mRNA single cell analysis. […] We propose GCTB patients with PM receive regular chest surveillance with PET scan and/or CT to monitor disease progression, and a multi-centre audit of GCTB outcome undertaken to further define optimal clinical management.

• #66 Pathology & Oncology Research | Management and surveillance of metastatic giant cell tumour of bone

  https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2025.1611916/full

  The primary aim of this study was to determine the true incidence of PM and current surveillance protocols. […] To identify occult and metastatic pulmonary disease, patients are routinely followed up with surveillance scanning of extremity and thoracic imaging with PET/CT. […] Differences between surveillance protocols across specialist sarcoma centres were found. […] It has been previously suggested that GCTB warrants strict follow-up due to the risk of GCTB malignant transformation and metastatic spread which although rare, carries significant morbidity and mortality. […] We would recommend baseline CT chest or PET-CT at diagnosis, with a follow-up CT chest 6 months after surgery or if there is evidence of LR at primary site. Then three monthly chest x-ray up to 2 years, six monthly from 2–5 years, annually from 5–10 years. If PM found, CT chest/PET and MDT review with cardiothoracics for management of resectable disease. […] High incidence of PM of >9% was observed in this study, which is higher than reported historically.

• #67 diagnostic approach to bone metastasis of unknown origin: a systematic review | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/123441-diagnostic-approach-to-bone-metastasis-of-unknown-origin-a-systematic-review

  Among all MBD cases, 3% have an unidentified origin and are commonly misdiagnosed. On average, nearly 75% of MBD cases with an unknown origin take four months to diagnose. This difficulty in identifying the primary cancer limits the treatment of skeletal metastases to palliative measures, negatively impacting a patients prognosis. […] The overall survival rate of MBD patients is approximately 5% five years after diagnosis, and this number drops to 1% after ten years, with a median survival of 5 months post-diagnosis. Diagnostic delay has been identified as a significant factor contributing to unfavorable patient outcomes, combined with the overall burden imposed by the unknown primary lesion of MBD. […] Biopsy is crucial in identifying the primary lesion of metastatic bone disease with an unknown origin, with a detection rate of 38.2%, making it the most frequently recommended examination.

• #68 diagnostic approach to bone metastasis of unknown origin: a systematic review | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/123441-diagnostic-approach-to-bone-metastasis-of-unknown-origin-a-systematic-review

  The diagnostic process began with history taking and physical examination, followed by laboratory examinations. […] Finally, biopsy was the most frequently recommended examination for identifying the primary origin of MBD. […] Our systematic review reported bone scan sensitivity as high as 83.3%, although past studies have shown sensitivity up to 50%. […] This systematic review has highlighted the importance of biopsy, with the highest detection rate of 38.2%. […] We recommend a shorter initial work-up before performing a biopsy, as this would result in faster diagnosis and treatment administration.

• #69 diagnostic approach to bone metastasis of unknown origin: a systematic review | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/123441-diagnostic-approach-to-bone-metastasis-of-unknown-origin-a-systematic-review

  The diagnostic process began with history taking and physical examination, followed by laboratory examinations. […] Finally, biopsy was the most frequently recommended examination for identifying the primary origin of MBD. […] Our systematic review reported bone scan sensitivity as high as 83.3%, although past studies have shown sensitivity up to 50%. […] This systematic review has highlighted the importance of biopsy, with the highest detection rate of 38.2%. […] We recommend a shorter initial work-up before performing a biopsy, as this would result in faster diagnosis and treatment administration.

• #70 Bone Metastases | Cancer Spread to Bones | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/advanced-cancer/bone-metastases.html

  When cancer cells spread to the bones (bone metastases), they can cause many problems such as pain, broken bones, or more serious problems. Almost all cancers can spread to the bone, but cancers that often spread there include breast, lung, prostate, kidney, melanoma, ovarian, and thyroid. The spine is the most common site for bone metastases. Other common sites are the hip bone (pelvis), upper leg bone (femur), upper arm bone (humerus), ribs, and the skull. […] Finding and treating bone metastases early can help prevent problems later. […] Bone mets may be seen on imaging tests that take pictures of the body. Some common imaging tests used to check for bone mets include: X-ray, CT or CAT scan, MRI, PET scan, Bone scan. […] The drugs used most often for treating bone problems in people with bone metastases are the bisphosphonate drugs pamidronate (Aredia) and zoledronic acid (Zometa) and the drug denosumab (Xgeva). These drugs are given intravenously (IV or into a vein) or subcutaneously (under the skin). Most patients are treated once a month at first, but may be able to be treated less often later on if they are doing well. Treatment with one of these drugs can help prevent further bone damage and events related to weakened bones such as fractures, hypercalcemia, and spinal cord compression.

• #71 Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/7/393

  Unfortunately, most patients have already sustained a pathologic fracture by the time they present to an orthopedic team and thus have a greater likelihood of severe discomfort and increased morbidity during the treatment process. […] Heightened awareness in the primary care setting of possible metastatic bone disease is essential in patients who present with musculoskeletal pain and a history of cancer or previous radiotherapy. […] The management of patients with skeletal events due to bone metastasis has important implications for healthcare costs. Early intervention for patients with metastatic bone disease has been shown to reduce patient morbidity as well as overall cost. […] A prompt, proactive response has been shown to reduce complication rates, length of stay, need for community care, and overall treatment costs, and this is specifically true of pathologic fracture. […] A prophylactic approach has shown to be safer and much more cost-effective compared with traditional management, or acute fixation, after a completed fracture. […] The appropriate surgical approach and choice of implant have the potential to reduce healthcare costs.

• #72 Bone Metastasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507911/

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). Metastases may present with a single bone lesion, oligometastatic disease, multiple bone metastases, or visceral plus bone metastases. A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] The management of a patient with bone metastases requires an interprofessional approach. The therapeutic approach to bone metastases should be an interprofessional approach targeted at preserving the quality of life, including pain control, minimizing SREs, and achieving local tumor control. It is pertinent to consider a multitude of factors including the extent of disease spread, performance status, impending fracture, and side effects when creating the initial approach for the treatment of bone metastases.

• #73 Bone Metastasis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18450

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). […] A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] It is pertinent to identify bone metastasis early, both for staging and prognostication as well as the implementation of prophylactic and treatment strategies which may lead to decreased morbidity and mortality.

• #74 Survival after bone metastasis by primary cancer type: a Danish population-based cohort study | BMJ Open

  https://bmjopen.bmj.com/content/7/9/e016022

  In the 10 most common primary types with bone metastases, we aimed to examine survival, further stratifying on bone metastases only or with additional synchronous metastases. […] We included 17251 patients with bone metastasis. The most common primary cancer types with bone metastasis were prostate (34%), breast (22%) and lung (20%). One-year survival after bone metastasis diagnosis was lowest in patients with lung cancer (10%, 95% CI 9% to 11%) and highest in patients with breast cancer (51%, 50% to 53%). At 5 years of follow-up, only patients with breast cancer had over 10% survival (13%, 11% to 14%). The risk of mortality was increased for the majority of cancer types among patients with bone and synchronous metastases compared with bone only (adjusted relative risk 1.291.57), except for cervix, ovarian and bladder cancer.

• #75 Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study

  https://atm.amegroups.org/article/view/39755/html

  The results of this study provide population-based estimates for the incidence rates of patients with bone metastases at initial diagnosis of their solid tumor. The findings can help clinicians to early detect bone metastases by bone screening to anticipate the occurrence of symptoms and favorably improve the prognosis. […] The incidence of bone metastases among the metastatic subset was 88.74% in prostate cancer, 53.71% in breast cancer, and 38.65% in renal cancer. […] The incidence of bone metastases was higher, and survival time was shorter among patients with more extensive metastases at diagnosis. […] Our results show that cancer presented at diagnosis with bone metastases with the longest median survival time is breast cancer (27 months), followed by prostate cancer (25 months), and thyroid cancer (23 months).

• #76 diagnostic approach to bone metastasis of unknown origin: a systematic review | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/123441-diagnostic-approach-to-bone-metastasis-of-unknown-origin-a-systematic-review

  Among all MBD cases, 3% have an unidentified origin and are commonly misdiagnosed. On average, nearly 75% of MBD cases with an unknown origin take four months to diagnose. This difficulty in identifying the primary cancer limits the treatment of skeletal metastases to palliative measures, negatively impacting a patients prognosis. […] The overall survival rate of MBD patients is approximately 5% five years after diagnosis, and this number drops to 1% after ten years, with a median survival of 5 months post-diagnosis. Diagnostic delay has been identified as a significant factor contributing to unfavorable patient outcomes, combined with the overall burden imposed by the unknown primary lesion of MBD. […] Biopsy is crucial in identifying the primary lesion of metastatic bone disease with an unknown origin, with a detection rate of 38.2%, making it the most frequently recommended examination.

• #77 Epidemiology of bone metastases – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33276151/

  Background: This study evaluated the incidence of de novo bone metastasis across all primary cancer sites and their impact on survival by primary cancer site, age, race, and sex. […] Our objectives were (I) characterize the epidemiology of de novo bone metastasis with respect to patient demographics, (II) characterize the incidence by primary site, age, and sex (2010-2015), and (III) compare survival of de novo metastatic cancer patients with and without bone metastasis. […] Of patients with cancer in the SEER database, 5.1% were diagnosed with metastasis to bone, equaling ~18.8 per 100,000 bone metastasis diagnoses in the US per year (2010-2015). […] The presence of de novo bone metastasis was associated with a limited reduction in overall survival (HR = 1.02, 95%, CI = [1.01-1.03], p 0.001) when compared to patients with other non-bone metastases. […] The presence of bone metastasis versus metastasis to other sites has disease site-specific impact on survival. The incidence of de novo bone metastasis varies by age, sex, and primary disease site.

• #78 Epidemiology of bone metastases – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33276151/

  Background: This study evaluated the incidence of de novo bone metastasis across all primary cancer sites and their impact on survival by primary cancer site, age, race, and sex. […] Our objectives were (I) characterize the epidemiology of de novo bone metastasis with respect to patient demographics, (II) characterize the incidence by primary site, age, and sex (2010-2015), and (III) compare survival of de novo metastatic cancer patients with and without bone metastasis. […] Of patients with cancer in the SEER database, 5.1% were diagnosed with metastasis to bone, equaling ~18.8 per 100,000 bone metastasis diagnoses in the US per year (2010-2015). […] The presence of de novo bone metastasis was associated with a limited reduction in overall survival (HR = 1.02, 95%, CI = [1.01-1.03], p 0.001) when compared to patients with other non-bone metastases. […] The presence of bone metastasis versus metastasis to other sites has disease site-specific impact on survival. The incidence of de novo bone metastasis varies by age, sex, and primary disease site.

• #79 Survival after bone metastasis by primary cancer type: a Danish population-based cohort study | BMJ Open

  https://bmjopen.bmj.com/content/7/9/e016022

  While patients with bone metastases after most primary cancers have poor survival, one of ten patients with bone metastasis from breast cancer survived 5 years. […] Population-based reports on length of survival after bone metastases from many primary cancer types are lacking. In patients with breast, prostate and renal cancer, the reported median survival ranges from 12 to 33 months for patients with bone metastases, and survival increases with longer time between primary diagnosis and such metastases. On the other hand, survival is low for patients with primary lung cancer and bone metastases, 1-year survival ranging from 9.5% to 12%. […] In this large heterogeneous cohort of 17251 patients with bone metastasis in the 10 specific primary cancer types where bone metastases are most commonly observed, we find that the prognosis after diagnosis of bone metastasis is depending on primary cancer type. Furthermore, the prognosis is poorer when other metastases are present at the time of bone metastasis diagnosis.

• #80 Survival after bone metastasis by primary cancer type: a Danish population-based cohort study | BMJ Open

  https://bmjopen.bmj.com/content/7/9/e016022

  In the 10 most common primary types with bone metastases, we aimed to examine survival, further stratifying on bone metastases only or with additional synchronous metastases. […] We included 17251 patients with bone metastasis. The most common primary cancer types with bone metastasis were prostate (34%), breast (22%) and lung (20%). One-year survival after bone metastasis diagnosis was lowest in patients with lung cancer (10%, 95% CI 9% to 11%) and highest in patients with breast cancer (51%, 50% to 53%). At 5 years of follow-up, only patients with breast cancer had over 10% survival (13%, 11% to 14%). The risk of mortality was increased for the majority of cancer types among patients with bone and synchronous metastases compared with bone only (adjusted relative risk 1.291.57), except for cervix, ovarian and bladder cancer.

• #81

  https://step2.medbullets.com/oncology/120441/metastatic-cancer-to-bone

  Metastatic cancer is the most common reason for a destructive bone lesion in adults. […] Bone is the third most common site for metastatic disease (behind lung and liver). […] Metastatic bone lesions are usually found in older patients (40 yrs). […] Common sites of metastatic lesions include axial skeleton (vertebral bodies, pelvis, ribs). […] Proximal femur is the most common site of fracture secondary to metastatic bone lesions. […] Median survival in patients with metastatic bone disease: thyroid: 48 months, prostate: 40 months, breast: 24 months, kidney: variable depending on medical condition but may be as short as 6 months, lung: 6 months.

• #82 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  If several areas of the skeletal system are affected by cancer then radiation, in the form of radiopharmaceuticals, can be administered via IV injection into the blood stream through a vein. […] Factors that impact metastatic prostate cancer prognosis include: Extent of metastasis: The number and location of metastatic sites can affect prognosis. […] Survival rates for metastatic prostate cancer can vary widely depending on individual factors. According to the American Cancer Society, the 5-year relative survival rate for distant (metastatic) prostate cancer is about 34%. […] Remember, while metastatic prostate cancer is a serious diagnosis, many patients can live for several years with appropriate treatment and support.

• #83 Bone Metastatic Breast Cancer: Advances in Cell Signaling and Autophagy Related Mechanisms

  https://www.mdpi.com/2072-6694/13/17/4310

  Metastatic bone disease places an increased burden upon healthcare systems and may be a significant driver of total oncologic expenditure. […] Current estimates show that breast cancer is the most common form of cancer among women within the US, and it projected to account for 15% of all cancers diagnosed, and 7% of cancer related deaths within the US during 2020. […] Metastatic tumors within the bone can display osteolytic, osteoblastic, and mixed lesions. Osteolytic tumors account for upwards of 80% of bone metastatic tumors in breast cancer patients. […] Treatment options and clinical outcomes vary between subtypes of breast cancer. […] Recent studies examining the metastatic profiles of various breast cancer subtypes have shown that the bone is the most frequent site of metastasis irrespective of molecular subtype or the presence of metastatic tumors in several sites, with the brain, liver, and lung representing other preferred sites of metastasis.

• #84 Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/7/393

  It is estimated that more than half of all cancers develop bony metastases, exacting a substantial cost in terms of patient quality of life and healthcare expenses. […] A multidisciplinary approach is needed to identify an appropriate treatment plan for the patient based on the prognosis, fracture status, and extent of skeletal disease. […] Most patients with metastatic bone disease present to an orthopedic team after a pathologic fracture has already occurred, increasing the likelihood of discomfort and morbidity. […] Awareness of the diagnostic and therapeutic challenges associated with metastatic bone disease is essential for timely referral to an orthopedic specialist. […] The estimated cost directly attributed to care of bone metastasis in the United States is greater than $12.6 billion annually, which accounts for 17% of total cancer care.

• #85 Chapter 2 – Epidemiology of primary bone tumors and economical aspects of bone metastases | Sustainable Development Goals – Resource Centre

  https://sdgresources.relx.com/book-chapters/chapter-2-epidemiology-primary-bone-tumors-and-economical-aspects-bone-metastases

  Primary bone tumors are rare; they account for less than 0.2% of the malignancies registered. […] Both benign as well as malignant primary tumors of bone are outnumbered by far by metastases to the bone. After lung and liver, the skeletal system is the most common site to be involved by metastatic tumor. […] Studies on the economic impact of bone metastasis are rare and only report on the costs for the health-care sector. The cost burden for metastatic bone disease was 17% of the estimated total direct medical costs. The financial impact is more substantial for patients with cancer at younger age and for cancer types with prolonged survival even with bony metastasis.

• #86 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  The economic burden of cancer, however, is much greater than just the direct healthcare cost, and also includes indirect costs. These are the monetary losses associated with time spent receiving medical care, time lost from work or other usual activities (morbidity costs), and lost productivity due to premature death (mortality costs). These costs are borne by patients, caregivers, families, employers and society as a whole. […] The treatment cost of skeletal metastases is exceedingly high, especially in the case of SREs. They are associated with a significant consumption of healthcare resources, that generate a substantial economic burden for the healthcare system. The vast majority of the associated health resource utilization is derived from a requirement for prolonged hospital stays, numerous outpatient visits and a substantial number of procedures.

• #87 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  The economic burden of cancer, however, is much greater than just the direct healthcare cost, and also includes indirect costs. These are the monetary losses associated with time spent receiving medical care, time lost from work or other usual activities (morbidity costs), and lost productivity due to premature death (mortality costs). These costs are borne by patients, caregivers, families, employers and society as a whole. […] The treatment cost of skeletal metastases is exceedingly high, especially in the case of SREs. They are associated with a significant consumption of healthcare resources, that generate a substantial economic burden for the healthcare system. The vast majority of the associated health resource utilization is derived from a requirement for prolonged hospital stays, numerous outpatient visits and a substantial number of procedures.

• #88 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  As cancer progresses and becomes more advanced, the cost of treatment increases. The individual and societal economic burden is higher in patients who develop MBD compared to those who have more localized forms of cancer, and this burden further increases in those who subsequently develop a SRE. […] Regardless of the primary tumor, the treatment of patients who develop MBD and SREs remains a significant challenge and burden on any healthcare system. The utilization of health care resources can however vary according to the specific type of SRE. The vast majority of the associated cost is driven by the need for (often lengthy) inpatient stays, outpatient visits, as well as a substantial number of procedures. […] The complexity of measuring the financial hardship of cancer has led to substantial heterogeneity in methods and measures. The main domains to analyze are: (I) productivity loss, (II) out of pocket medical care costs, and (III) depletion of assets as a result of the first two domains, leading to an increased risk for medical debt, bankruptcy, and increased stress, anxiety, and worry about finances.

• #89 Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/7/393

  Unfortunately, most patients have already sustained a pathologic fracture by the time they present to an orthopedic team and thus have a greater likelihood of severe discomfort and increased morbidity during the treatment process. […] Heightened awareness in the primary care setting of possible metastatic bone disease is essential in patients who present with musculoskeletal pain and a history of cancer or previous radiotherapy. […] The management of patients with skeletal events due to bone metastasis has important implications for healthcare costs. Early intervention for patients with metastatic bone disease has been shown to reduce patient morbidity as well as overall cost. […] A prompt, proactive response has been shown to reduce complication rates, length of stay, need for community care, and overall treatment costs, and this is specifically true of pathologic fracture. […] A prophylactic approach has shown to be safer and much more cost-effective compared with traditional management, or acute fixation, after a completed fracture. […] The appropriate surgical approach and choice of implant have the potential to reduce healthcare costs.

• #90 Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/7/393

  Unfortunately, most patients have already sustained a pathologic fracture by the time they present to an orthopedic team and thus have a greater likelihood of severe discomfort and increased morbidity during the treatment process. […] Heightened awareness in the primary care setting of possible metastatic bone disease is essential in patients who present with musculoskeletal pain and a history of cancer or previous radiotherapy. […] The management of patients with skeletal events due to bone metastasis has important implications for healthcare costs. Early intervention for patients with metastatic bone disease has been shown to reduce patient morbidity as well as overall cost. […] A prompt, proactive response has been shown to reduce complication rates, length of stay, need for community care, and overall treatment costs, and this is specifically true of pathologic fracture. […] A prophylactic approach has shown to be safer and much more cost-effective compared with traditional management, or acute fixation, after a completed fracture. […] The appropriate surgical approach and choice of implant have the potential to reduce healthcare costs.

• #91 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  As cancer progresses and becomes more advanced, the cost of treatment increases. The individual and societal economic burden is higher in patients who develop MBD compared to those who have more localized forms of cancer, and this burden further increases in those who subsequently develop a SRE. […] Regardless of the primary tumor, the treatment of patients who develop MBD and SREs remains a significant challenge and burden on any healthcare system. The utilization of health care resources can however vary according to the specific type of SRE. The vast majority of the associated cost is driven by the need for (often lengthy) inpatient stays, outpatient visits, as well as a substantial number of procedures. […] The complexity of measuring the financial hardship of cancer has led to substantial heterogeneity in methods and measures. The main domains to analyze are: (I) productivity loss, (II) out of pocket medical care costs, and (III) depletion of assets as a result of the first two domains, leading to an increased risk for medical debt, bankruptcy, and increased stress, anxiety, and worry about finances.

• #92 Epidemiology, clinical presentation, and diagnosis of bone metastasis in adults – UpToDate

  https://www.uptodate.com/contents/epidemiology-clinical-presentation-and-diagnosis-of-bone-metastasis-in-adults

  Epidemiology, clinical presentation, and diagnosis of bone metastasis in adults […] Bone metastases are a common manifestation of distant relapse from many types of solid cancers, especially those arising in the lung, breast, and prostate. Bone is the third most common organ affected by metastases, after the lung and liver. For hematologic malignancies, bone involvement can also be extensive in patients with multiple myeloma, and bone may be a primary or secondary site of disease involvement in patients with lymphoma. […] Bone metastases represent a prominent source of morbidity. Skeletal-related events (SREs) that are due to bone metastases can include pain, pathologic fracture, hypercalcemia, and spinal cord compression. Across a wide variety of tumors involving bone, the frequency of SREs can be reduced using osteoclast inhibitors, such as bisphosphonates or denosumab.

• #93 Epidemiology, clinical presentation, and diagnosis of bone metastasis in adults – UpToDate

  https://www.uptodate.com/contents/epidemiology-clinical-presentation-and-diagnosis-of-bone-metastasis-in-adults

  Epidemiology, clinical presentation, and diagnosis of bone metastasis in adults […] Bone metastases are a common manifestation of distant relapse from many types of solid cancers, especially those arising in the lung, breast, and prostate. Bone is the third most common organ affected by metastases, after the lung and liver. For hematologic malignancies, bone involvement can also be extensive in patients with multiple myeloma, and bone may be a primary or secondary site of disease involvement in patients with lymphoma. […] Bone metastases represent a prominent source of morbidity. Skeletal-related events (SREs) that are due to bone metastases can include pain, pathologic fracture, hypercalcemia, and spinal cord compression. Across a wide variety of tumors involving bone, the frequency of SREs can be reduced using osteoclast inhibitors, such as bisphosphonates or denosumab.

• #94 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  The incidence of SRE in MBD is high. In a study of patients with newly diagnosed MBD, SREs were present in 22% of the patients at diagnosis of bone disease. Of those not presenting with an SRE at diagnosis, 47% of lung cancer patients, 46% of prostate cancer and 52% of breast cancer patients experienced an SRE during the follow-up period. Similarly, in another long term study, the cumulative incidences of SREs were 47%, 31.4% and 38% in breast cancer, prostate cancer and multiple myeloma, respectively. Furthermore, patients with MBD often experience multiple SREs, that typically occur at a more rapid rate following the initial event. […] Generally, and with the exception of selected cases with single metastases from renal or breast cancer, the diagnosis of MBD signifies that the disease is incurable. However, especially with advancements in the field of oncology, patients with MBD may survive for an extended period of time. Subsequently, they are at risk of developing SREs. They pose a significant clinical concern and delaying or preventing them is an important treatment objective.

• #95 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  The incidence of SRE in MBD is high. In a study of patients with newly diagnosed MBD, SREs were present in 22% of the patients at diagnosis of bone disease. Of those not presenting with an SRE at diagnosis, 47% of lung cancer patients, 46% of prostate cancer and 52% of breast cancer patients experienced an SRE during the follow-up period. Similarly, in another long term study, the cumulative incidences of SREs were 47%, 31.4% and 38% in breast cancer, prostate cancer and multiple myeloma, respectively. Furthermore, patients with MBD often experience multiple SREs, that typically occur at a more rapid rate following the initial event. […] Generally, and with the exception of selected cases with single metastases from renal or breast cancer, the diagnosis of MBD signifies that the disease is incurable. However, especially with advancements in the field of oncology, patients with MBD may survive for an extended period of time. Subsequently, they are at risk of developing SREs. They pose a significant clinical concern and delaying or preventing them is an important treatment objective.

• #96 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  The incidence of SRE in MBD is high. In a study of patients with newly diagnosed MBD, SREs were present in 22% of the patients at diagnosis of bone disease. Of those not presenting with an SRE at diagnosis, 47% of lung cancer patients, 46% of prostate cancer and 52% of breast cancer patients experienced an SRE during the follow-up period. Similarly, in another long term study, the cumulative incidences of SREs were 47%, 31.4% and 38% in breast cancer, prostate cancer and multiple myeloma, respectively. Furthermore, patients with MBD often experience multiple SREs, that typically occur at a more rapid rate following the initial event. […] Generally, and with the exception of selected cases with single metastases from renal or breast cancer, the diagnosis of MBD signifies that the disease is incurable. However, especially with advancements in the field of oncology, patients with MBD may survive for an extended period of time. Subsequently, they are at risk of developing SREs. They pose a significant clinical concern and delaying or preventing them is an important treatment objective.

• #97 Predictive and prognostic biomarkers of bone metastasis in breast cancer: current status and future directions | Cell & Bioscience | Full Text

  https://cellandbioscience.biomedcentral.com/articles/10.1186/s13578-023-01171-8

  The most common site of metastasis in breast cancer is the bone, where the balance between osteoclast-mediated bone resorption and osteoblast-mediated bone formation is disrupted. This imbalance causes osteolytic bone metastasis in breast cancer, which leads to bone pain, pathological fractures, spinal cord compression, and other skeletal-related events (SREs). These complications reduce patients’ quality of life significantly and have a profound impact on prognosis. […] According to a report by Leone et al., among 9143 stage IV breast cancer patients, the incidence of bone metastasis at the time of initial diagnosis was 37.5%, while visceral metastasis and metastasis to other sites were 21% and 11.9%, respectively. […] Bone metastasis in breast cancer is challenging to treat and can lead to complications including bone pain, pathological fractures, hypercalcemia, and spinal cord compression, which are collectively known as skeletal-related events (SREs). SREs significantly impact patients’ quality of life and reduce survival rates.

• #98 Metastatic Bone Cancer, Bone Metastases | Froedtert & MCW

  https://www.froedtert.com/metastatic-bone-disease

  Cancer Services […] More than half of all cancer patients will develop bone metastases. […] Survival after you have been diagnosed with bone metastasis varies depending on how early the diagnosis, the original site of the cancer, response to treatment and many individual health factors. […] Metastatic bone disease can weaken and damage the bone, making patients prone to fractures. […] As part of your cancer treatment, your team may be able to take steps to lessen the chances that the cancer will spread to your bones. […] You have the best chance of surviving if bone metastases are found and treated early. […] The first step is accurate diagnosis with imaging such as X-rays, CT scans or MRI to find out how far the disease has spread. […] Patients with metastatic bone disease need comprehensive, well-coordinated care from a variety of disciplines.

• #99 Lytic bone metastases | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/lytic-bone-metastases-1?lang=us

  Lytic bone metastases are more common than sclerotic bone metastases. […] Bone metastases represent a major cause of morbidity, with symptoms that include severe pain and impaired mobility. […] Osteolytic metastases have a higher fracture risk than mixed or sclerotic bone metastases. […] Sclerosis of lytic bone metastases without evidence of new metastases is accepted to represent treatment response.

• #100 Bone Metastasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507911/

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). Metastases may present with a single bone lesion, oligometastatic disease, multiple bone metastases, or visceral plus bone metastases. A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] The management of a patient with bone metastases requires an interprofessional approach. The therapeutic approach to bone metastases should be an interprofessional approach targeted at preserving the quality of life, including pain control, minimizing SREs, and achieving local tumor control. It is pertinent to consider a multitude of factors including the extent of disease spread, performance status, impending fracture, and side effects when creating the initial approach for the treatment of bone metastases.

• #101 Bone Metastasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507911/

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). Metastases may present with a single bone lesion, oligometastatic disease, multiple bone metastases, or visceral plus bone metastases. A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] The management of a patient with bone metastases requires an interprofessional approach. The therapeutic approach to bone metastases should be an interprofessional approach targeted at preserving the quality of life, including pain control, minimizing SREs, and achieving local tumor control. It is pertinent to consider a multitude of factors including the extent of disease spread, performance status, impending fracture, and side effects when creating the initial approach for the treatment of bone metastases.

• #102 Bone Metastasis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507911/

  Bone metastases affect survival rates ranging from 6 to 7 months in lung cancer to several years in the breast (19 to 25 months) or prostate cancer (12 to 53 months). Metastases may present with a single bone lesion, oligometastatic disease, multiple bone metastases, or visceral plus bone metastases. A study by Hernandez et al. estimated the cumulative incidence of bone metastases in the United States as 2.9% at 30 days, 4.8% at one year, 5.6% at two years, 6.9% at five years, and 8.4% at ten years. Prostate cancer posed the highest risk for bone metastases (18% to 29%) followed by lung, renal, or breast cancer. […] The management of a patient with bone metastases requires an interprofessional approach. The therapeutic approach to bone metastases should be an interprofessional approach targeted at preserving the quality of life, including pain control, minimizing SREs, and achieving local tumor control. It is pertinent to consider a multitude of factors including the extent of disease spread, performance status, impending fracture, and side effects when creating the initial approach for the treatment of bone metastases.

• #103 Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease – DiCaprio – Annals of Joint

  https://aoj.amegroups.org/article/view/6807/html

  The care of patients with MBD can become complicated and challenging. Orthopedic opinions are often sought far too late and earlier referral may offer the opportunity for less complications. The myriad of impacts MBD has on patients, caregivers and society must be taken into consideration by the entire multi-disciplinary team caring for those with advanced cancer.

• #104 Metastatic Bone Cancer, Bone Metastases | Froedtert & MCW

  https://www.froedtert.com/metastatic-bone-disease

  Cancer Services […] More than half of all cancer patients will develop bone metastases. […] Survival after you have been diagnosed with bone metastasis varies depending on how early the diagnosis, the original site of the cancer, response to treatment and many individual health factors. […] Metastatic bone disease can weaken and damage the bone, making patients prone to fractures. […] As part of your cancer treatment, your team may be able to take steps to lessen the chances that the cancer will spread to your bones. […] You have the best chance of surviving if bone metastases are found and treated early. […] The first step is accurate diagnosis with imaging such as X-rays, CT scans or MRI to find out how far the disease has spread. […] Patients with metastatic bone disease need comprehensive, well-coordinated care from a variety of disciplines.

• #105 Metastatic Bone Cancer, Bone Metastases | Froedtert & MCW

  https://www.froedtert.com/metastatic-bone-disease

  Treatment for cancer that is spreading can’t wait, so experts in our Metastatic Bone Disease Program mapped out all of the different types of primary cancer that can metastasize to the bones. […] A team approach to treating cancer that has spread to the bones is important for planning your best treatment.

• #106 Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/7/393

  Unfortunately, most patients have already sustained a pathologic fracture by the time they present to an orthopedic team and thus have a greater likelihood of severe discomfort and increased morbidity during the treatment process. […] Heightened awareness in the primary care setting of possible metastatic bone disease is essential in patients who present with musculoskeletal pain and a history of cancer or previous radiotherapy. […] The management of patients with skeletal events due to bone metastasis has important implications for healthcare costs. Early intervention for patients with metastatic bone disease has been shown to reduce patient morbidity as well as overall cost. […] A prompt, proactive response has been shown to reduce complication rates, length of stay, need for community care, and overall treatment costs, and this is specifically true of pathologic fracture. […] A prophylactic approach has shown to be safer and much more cost-effective compared with traditional management, or acute fixation, after a completed fracture. […] The appropriate surgical approach and choice of implant have the potential to reduce healthcare costs.

• #107 Metastatic bone disease: Early referral for multidisciplinary care | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/7/393

  Unfortunately, most patients have already sustained a pathologic fracture by the time they present to an orthopedic team and thus have a greater likelihood of severe discomfort and increased morbidity during the treatment process. […] Heightened awareness in the primary care setting of possible metastatic bone disease is essential in patients who present with musculoskeletal pain and a history of cancer or previous radiotherapy. […] The management of patients with skeletal events due to bone metastasis has important implications for healthcare costs. Early intervention for patients with metastatic bone disease has been shown to reduce patient morbidity as well as overall cost. […] A prompt, proactive response has been shown to reduce complication rates, length of stay, need for community care, and overall treatment costs, and this is specifically true of pathologic fracture. […] A prophylactic approach has shown to be safer and much more cost-effective compared with traditional management, or acute fixation, after a completed fracture. […] The appropriate surgical approach and choice of implant have the potential to reduce healthcare costs.

• #108 Predictive and prognostic biomarkers of bone metastasis in breast cancer: current status and future directions | Cell & Bioscience | Full Text

  https://cellandbioscience.biomedcentral.com/articles/10.1186/s13578-023-01171-8

  The development of highly accurate and reliable biomarkers is crucial. These biomarkers have the potential to aid in early diagnosis, risk assessment, and treatment stratification for breast cancer patients with bone metastasis. […] The future trajectory of research in breast cancer bone metastasis should be guided by several key objectives: 1) Mechanistic Understanding: Continued efforts should be dedicated to deepening our understanding of the intricate mechanisms that drive breast cancer bone metastasis. This knowledge will pave the way for more targeted and effective treatments. 2) Biomarker Development: The development of highly accurate and reliable biomarkers is crucial. These biomarkers have the potential to aid in early diagnosis, risk assessment, and treatment stratification for breast cancer patients with bone metastasis. 3) Clinical Validation: It is imperative to subject these biomarkers to extensive large-scale clinical validation to ensure their robustness and reliability. This step is essential before their potential implementation in routine clinical practice. 4) Therapeutic Targets: Exploring whether these biomarkers can also serve as therapeutic targets is a promising avenue of investigation. Targeted therapies based on these biomarkers may offer more effective and personalized treatment options.

Zobacz więcej