Bone metastases: a comprehensive review of the literature
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REVIEW
Bone metastases: a comprehensive review of the literature Filippo Migliorini1 · Nicola Maffulli2,3,4 · Andromahi Trivellas5 · Jörg Eschweiler1 · Markus Tingart1 · Arne Driessen1 Received: 27 April 2020 / Accepted: 26 July 2020 © Springer Nature B.V. 2020
Abstract The last report of the World Health Organization (WHO) stated that approximately four million people experience bone pain due to malignant diseases. Among them, metastatic bone pain is one of the most important sources of complaint. The estimated median survival in the presence of bone metastases ranks from 10 to 12 weeks. Bone represents a potential target of distant metastases for the majority of malignant tumours. However, the exact incidence of bone metastases is unknown. Bone metastases have an important socio-economic impact, and due to the enhancement of the overall survivorship, their incidence is increasing. Malignant neoplasms such as lung, thyroid, renal cancer, multiple myeloma, and melanoma often metastasize to the bone. Bone metastases commonly localize to the spinal column, pelvis, shoulder, and distal femur. The proper treatment for painful skeletal metastases is still unknown. Hence, the purpose of this review of the literature was to update current evidence concerning the aetiogenesis, biological behaviour, and treatment algorithms for painful skeletal metastases. Keywords Bone · Metastases · Treatment
Introduction The latest cancer report of the World Health Organization (WHO) stated that approximately four million people experience bone pain due to malignant disease [1]. Among them, metastatic bone pain is one of the most important sources of complaint [1]. Bone metastases are debilitating, lead to pain, impaired mobility, hypercalcemia, pathological * Filippo Migliorini [email protected] 1
Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany
2
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Salerno, Italy
3
Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, London E1 4DG, England
4
School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, Stoke on Trent, England
5
Department of Orthopaedics, David Geffen School of Medicine At UCLA, Suite 755, Los Angeles, CA 90095, USA
fractures, and in the case of involvement of the spinal cord, neurological disorders and paralysis. Furthermore, the high quantity of calcium release into the circulatory system can lead to malign hypercalcemia, a serious medical illness [2] resulting in cardiac and kidney failure [3]. In the presence of bone metastases the median survival is described to range between 10 to 12 weeks [4]. Similar to organ parenchyma, bone represents a potential target of distant metastases for various malignant tumours [5]. The incidence of bone metastases is unknown [
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