Metastatic Bone Tumors: An Overview of Epidemiology, Diagnosis, and Treatment

Metastatic bone tumors (MBTs) are the most common malignant tumors seen in bone tumors: they cause destructive bone lesions in older age groups. MBTs are a common result of distant recurrence of many solid cancers. Approximately 80% of patients with solid tumors experience painful metastases in the spine, pelvis, and extremities during the course of their disease. MBTs is generally considered incurable; therefore, the primary goal of treatment is to reduce symptoms, preserve function, and improve the patient's quality of life. The most common primary tumors causing bone metastases are breast, prostate, and lung cancers. Workup including history, physical, radiographs, and CT chest, abdomen, pelvis identifies the primary tumor in about 85% of cases. In patients where a primary carcinoma is not identified, obtaining a biopsy is necessary to rule out a primary bone lesion. The prognosis for patients with metastatic bone disease is generally poor, with mean or median survival ranging from 6 to 15 months in most series. The choice of surgery is based on the patient's prognosis, tumor biology, response to radiotherapy, and the anatomical location of the lesion. Surgical treatment, medical treatments such as radiotherapy and bisphosphonates should be optimized by a multidisciplinary team, taking into account the patient's prognosis, quality of life, and postoperative functional expectations.