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Bone metastases in thyroid cancer

Whereas preemptive screening for the presence of lymph node and lung metastases is standard-of-care in thyroid cancer patients, bone metastases are less well studied and are often neglected in thyroid cancer patient surveillance. Bone metastases in thyroid cancer are, however, independently associat...

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Autores principales: Iñiguez-Ariza, Nicole M., Bible, Keith C., Clarke, Bart L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058902/
https://www.ncbi.nlm.nih.gov/pubmed/32154098
http://dx.doi.org/10.1016/j.jbo.2020.100282
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author Iñiguez-Ariza, Nicole M.
Bible, Keith C.
Clarke, Bart L.
author_facet Iñiguez-Ariza, Nicole M.
Bible, Keith C.
Clarke, Bart L.
author_sort Iñiguez-Ariza, Nicole M.
collection PubMed
description Whereas preemptive screening for the presence of lymph node and lung metastases is standard-of-care in thyroid cancer patients, bone metastases are less well studied and are often neglected in thyroid cancer patient surveillance. Bone metastases in thyroid cancer are, however, independently associated with poor/worse prognosis with a median overall survival from detection of only 4 years despite an otherwise excellent prognosis for the vast majority of thyroid cancer patients. In this review we summarize the state of current knowledge as pertinent to bony metastatic disease in thyroid cancer, including clinical implications, impacts on patient function and quality of life, pathogenesis, and therapeutic opportunities, proposing approaches to patient care accordingly. In particular, bone metastasis pathogenesis appears to reflect cooperatively between cancer and the bone microenvironment creating a “vicious cycle” of bone destruction rather than due exclusively to tumor invasion into bone. Additionally, bone metastases are more frequent in follicular and medullary thyroid cancers, requiring closer bone surveillance in patients with these histologies. Emerging data also suggest that treatments such as multikinase inhibitors (MKIs) can be less effective in controlling bone, as opposed to other (e.g. lung), metastases in thyroid cancers, making special attention to bone critical even in the setting of active MKI therapy. Although locoregional therapies including surgery, radiotherapy and ablation play important roles in palliation, antiresorptive agents including bisphosphonates and denosumab appear individually to delay and/or lessen skeletal morbidity and complications, with dosing frequency of every 3 months appearing optimal; their early application should therefore be strongly considered.
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spelling pubmed-70589022020-03-09 Bone metastases in thyroid cancer Iñiguez-Ariza, Nicole M. Bible, Keith C. Clarke, Bart L. J Bone Oncol Review Article Whereas preemptive screening for the presence of lymph node and lung metastases is standard-of-care in thyroid cancer patients, bone metastases are less well studied and are often neglected in thyroid cancer patient surveillance. Bone metastases in thyroid cancer are, however, independently associated with poor/worse prognosis with a median overall survival from detection of only 4 years despite an otherwise excellent prognosis for the vast majority of thyroid cancer patients. In this review we summarize the state of current knowledge as pertinent to bony metastatic disease in thyroid cancer, including clinical implications, impacts on patient function and quality of life, pathogenesis, and therapeutic opportunities, proposing approaches to patient care accordingly. In particular, bone metastasis pathogenesis appears to reflect cooperatively between cancer and the bone microenvironment creating a “vicious cycle” of bone destruction rather than due exclusively to tumor invasion into bone. Additionally, bone metastases are more frequent in follicular and medullary thyroid cancers, requiring closer bone surveillance in patients with these histologies. Emerging data also suggest that treatments such as multikinase inhibitors (MKIs) can be less effective in controlling bone, as opposed to other (e.g. lung), metastases in thyroid cancers, making special attention to bone critical even in the setting of active MKI therapy. Although locoregional therapies including surgery, radiotherapy and ablation play important roles in palliation, antiresorptive agents including bisphosphonates and denosumab appear individually to delay and/or lessen skeletal morbidity and complications, with dosing frequency of every 3 months appearing optimal; their early application should therefore be strongly considered. Elsevier 2020-02-19 /pmc/articles/PMC7058902/ /pubmed/32154098 http://dx.doi.org/10.1016/j.jbo.2020.100282 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Iñiguez-Ariza, Nicole M.
Bible, Keith C.
Clarke, Bart L.
Bone metastases in thyroid cancer
title Bone metastases in thyroid cancer
title_full Bone metastases in thyroid cancer
title_fullStr Bone metastases in thyroid cancer
title_full_unstemmed Bone metastases in thyroid cancer
title_short Bone metastases in thyroid cancer
title_sort bone metastases in thyroid cancer
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058902/
https://www.ncbi.nlm.nih.gov/pubmed/32154098
http://dx.doi.org/10.1016/j.jbo.2020.100282
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