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...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-04-01
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| Series: | Journal of Bone Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212137419302131 |
| _version_ | 1818930572802654208 |
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| author | Nicole M. Iñiguez-Ariza Keith C. Bible Bart L. Clarke |
| author_facet | Nicole M. Iñiguez-Ariza Keith C. Bible Bart L. Clarke |
| author_sort | Nicole M. Iñiguez-Ariza |
| collection | DOAJ |
| 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. Keywords: Thyroid cancer, Bone metastasis, Bisphosphonate, RANK ligand |
| first_indexed | 2024-12-20T04:02:50Z |
| format | Article |
| id | doaj.art-c6e392bd4cf540e78abe288e1b541e8d |
| institution | Directory Open Access Journal |
| issn | 2212-1374 |
| language | English |
| last_indexed | 2024-12-20T04:02:50Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj.art-c6e392bd4cf540e78abe288e1b541e8d2022-12-21T19:54:08ZengElsevierJournal of Bone Oncology2212-13742020-04-0121Bone metastases in thyroid cancerNicole M. Iñiguez-Ariza0Keith C. Bible1Bart L. Clarke2Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First Street SW Rochester, MN, 55905, USA; Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080 Ciudad de México, Mexico City, MexicoDivision of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Corresponding author at: Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, USA 55905.Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First Street SW Rochester, MN, 55905, USAWhereas 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. Keywords: Thyroid cancer, Bone metastasis, Bisphosphonate, RANK ligandhttp://www.sciencedirect.com/science/article/pii/S2212137419302131 |
| spellingShingle | Nicole M. Iñiguez-Ariza Keith C. Bible Bart L. Clarke Bone metastases in thyroid cancer Journal of Bone Oncology |
| 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 |
| url | http://www.sciencedirect.com/science/article/pii/S2212137419302131 |
| work_keys_str_mv | AT nicoleminiguezariza bonemetastasesinthyroidcancer AT keithcbible bonemetastasesinthyroidcancer AT bartlclarke bonemetastasesinthyroidcancer |