Zusammenfassung
Das Skelettsystem ist häufig der Metastasierungsort urologischer Karzinome. Ossäre Metastasen werden in osteoneutral, osteolytisch, osteoblastisch und gemischtförmig unterschieden. Osteolytisch wirkende Metastasen führen über Aktivierung der Osteoklasten zur Knochenresorption, wohingegen osteoblastische Metastasen durch parakrine Sekretion Osteoblasten aktivieren und so die Osteoneogenese fördern. Neben dem lokalen osteoblastischen Effekt kommt es zu einem sekundären systemischen Knochenabbau. Als supportive Therapie hat sich der Einsatz von Bisphosphonaten etabliert. Neue, z. T. noch experimentelle Ansätze bestehen in der gezielten Intervention in die Pathophysiologie der Knochenmetastasierung und der Radioimmuntherapie.
Abstract
The skeletal system is the most frequent metastatic site of hematogenous spread of urologic carcinomas. Osseus metastases are classified as osteoneutral, osteolytic, osteoblastic and combinations thereof. Osteolytic metastases lead to bone resorption by activating osteoclasts, while osteoblastic metastases stimulate osteoblasts by paracrine mechanisms. The local osteoblastic effect is associated with secondary systemic bone resorption. The use of bisphosphonates is now an established supportive therapy and newer treatment strategies including targeted intervention in the pathophysiology of bone metastases and radioimmunotherapy are being applied or will be coming soon.
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Sauer, G., Barth, T. & Möller, P. Pathophysiologie der Skelettmetastasierung urologischer Karzinome. Urologe 46, 888–890 (2007). https://doi.org/10.1007/s00120-007-1519-y
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DOI: https://doi.org/10.1007/s00120-007-1519-y