Metastatic tumours of bone

Abstract

Metastatic tumours of the bone are the most common types of bone cancer. Autopsy studies have shown that 70% of patients with breast and prostate carcinoma develop skeletal metastases. The most commonly involved bone sites are those with persistent red marrow, such as the vertebrae, proximal femur, ribs, sternum, pelvis and skull. The precise mechanism of metastases to bone is unclear, however, the understanding of the molecular biology of metastases is becoming increasingly important in providing new therapeutic targets. Treatment of bone metastases is multi-modal and may include medications, radiotherapy or surgery. Bone metastases can cause many complications and have significant morbidity. Traditionally, the presence of a metastatic bone deposit has been seen as a terminal event. With the increased survival and improved treatment of patients with carcinoma, long-term survival with metastatic bone disease is possible and treatment can prolong life, or even be curative. Implants used in reconstruction need to be sufficiently robust to survive the patient, and the expertise of reconstruction available within tertiary bone tumour units is increasingly required.

Posterior vertebral column resection as a safe procedure leading to solid bone fusion in metastatic epidural spinal cord compression

“…In lytic lesions, structural integrity is often impaired with a high risk of fragility fractures, potentially warranting surgical reconstruction. 15,16 Hence, after spinal spread of prostate cancer, the SINS is usually rather low and therefore reconstruction of the anterior column less often necessary.…”

“…[10][11][12][13][14] In lytic lesions, structural integrity is often impaired with a high risk of fractures, potentially warranting surgical reconstruction. 15,16 High doses of opioids are often required to manage the immobilizing pain following pathological fractures or metastatic epidural spinal cord compression (MESCC) due to tumor invasion of the epidural space. MESCC greatly decreases a patient's quality of life by functional and psychological sequelae, disability, and neuropathic pain.…”

Fibroblast growth factors signaling in bone metastasis

“…In contrast, other malignancies have a lower incidence of bone metastases (e.g. breast (50-60%) (Hess et al 2006), renal (35%), lung (35%), liver (13%), and rectal (10%) carcinoma (Hess et al 2006, Freeman et al 2015) and only prostate cancer has bone as a single, dominant metastatic site (Hess et al 2006). Additionally, multiple myeloma, a B cell malignancy, is the second most common haematological malignancy and, characteristically, involves bone during progression (Panaroni et al 2017).…”

Diagnostic Value of Plain Radiography for Symptomatic Bone Metastasis at the First Visit

“…In Japan, the number of elderly people aged 65 years or older continues to increase, and accordingly, the number of patients with cancer also continues to increase 1 . Among patients with either breast or prostate cancer, 70% develop bone metastases, and 25% of patients with breast cancer develop pathological fractures 2 . To prevent and minimize skeletal-related diseases, early diagnosis of bone metastases is important.…”