Biology and Pathophysiology of Bone Metastasis in Prostate Cancer

Several studies have attempted to correlate the extent of skeletal metastatic involvement, the number of bone metastases (BMTs) identified by bone scintigraphy or the distribution of BMTs (axial vs appendicular) with survival in patients with advanced prostate cancer (PC) [1, 2]. The number of BMTs has recently been evaluated as a prognostic predictor [3]. Patients with metastatic castration-resistant PC with a higher number of BMTs had a shorter progression-free survival (PFS) and overall survival (OS; hazard ratio 2.0; 95 % confidence interval 1.7–2.4). Patients with 1–4 BMTs have much better PFS and OS than those with 5–20 BMTs [4]. It should, however, be taken into account that among the predictors of prognosis, coexisting non-osseous metastatic disease is an important determinant of prognosis in patients with BMTs [5, 6

INel capitilo vengo presentate le più recenti acquisizioni in merito alla fisiopatlogia della malattia metastatica ossea e dell'interazine tra microambinete osteomidollare e cellula neopalstcia, dalla formazione della nicchia premetasatica alla sviiluppo della metastasi clinica