Bone is a major site of haematogenous tumour cell spread in renal cell carcinoma (RCC), and most patients with RCC will develop painful and functionally disabling bone metastases at advanced disease stages. The prognosis of these patients is generally poor and the treatment is, therefore, aimed at palliation. However, RCC-associated bone metastases can be curable in select patients. Current data support a multimodal management strategy that includes wide resection of lesions, radiotherapy, systemic therapy, and other local treatment options, which can improve quality of life and survival. Nevertheless, the optimal approach for metastatic bone disease in RCC has not yet been defined and practical recommendations are rare. To improve the management and outcomes of patients with RCC and bone metastases, the International Kidney Cancer Coalition and the interdisciplinary working group on renal tumours of the German Cancer Society convened a meeting of experts with a global perspective to perform an unstructured review and elaborate on current treatment strategies on the basis of published data and expertise. The panel formulated recommendations for the diagnosis and treatment of patients with RCC and metastasis to the bone. Furthermore, the experts summarized current challenges and unmet patient needs that should be addressed in the future.
Nature reviews. Urology. 2018 Jun 14 [Epub ahead of print]
Viktor Grünwald, Berit Eberhardt, Axel Bex, Anne Flörcken, Thomas Gauler, Thorsten Derlin, Martin Panzica, Hans Roland Dürr, Knut Achim Grötz, Rachel H Giles, Christian von Falck, Anno Graser, Alexander Muacevic, Michael Staehler
Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany. ., Uronauten e.V., Berlin, Germany., Division of Surgical Oncology, Department of Urology, The Netherlands Cancer Institute, Amsterdam, Netherlands., Department of Hematology, Oncology, and Tumor Immunology, Charité University Medicine Berlin, Berlin, Germany., Westdeutsches Tumorzentrum, Universitätsklinik Essen, Essen, Germany., Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany., Clinic of Trauma Surgery, Medical School Hannover, Hannover, Germany., Orthopaedic Oncology, Department of Orthopaedic Surgery, Ludwig-Maximilians University Munich, Munich, Germany., Department of Oral and Maxillofacial Surgery of the Dr Horst Schmidt Clinic, Wiesbaden, Germany., International Kidney Cancer Coalition, Duivendrecht, Netherlands., Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany., Radiologie München, Munich, Germany., European Cyberknife Center Munich-Großhadern, Munich, Germany., Department of Urology, Ludwig-Maximilians University Munich, Munich, Germany.