{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:05:43Z","timestamp":1793070343270,"version":"4.5.0"},"reference-count":44,"publisher":"Bioscientifica","issue":"9","content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Bone metastases (BMs) are a rare and late event in patients with neuroendocrine tumors (NETs). The aim of our study was to investigate the clinical presentation and outcome of BMs in a large cohort of patients with NETs. A retrospective study was performed at two referral centers of Northern Italy (IRCCS Humanitas Research Hospital in Milan and Santa Maria della Misericordia University Hospital in Udine). Three hundred fifty-two consecutive patients with either gastroenteropancreatic or non-gastroenteropancreatic NETs were included: 52 patients with synchronous or metachronous BMs (BM-positive) and 300 patients with metastatic disease without BMs (BM-negative). Patients with BMs showed a higher prevalence of smoking habit (41.2 vs 21.8%, P = 0.004) and carcinoid syndrome (28.8 vs 5.7%, P &amp;lt;0.001) compared to patients without BMs. In addition, higher levels of chromogranin A (P = 0.001), urinary 5-hydroxyindoleacetic acid (P &amp;lt;0.001), parathyroid hormone (P = 0.022), and alkaline phosphatase (P = 0.018) were found compared to the BM-negative group. Patients with BMs had more frequently a primary lung NET compared to the BM-negative group (19.2 vs 0.7%, P = 0.001) and grade G2 or G3 gastroenteropancreatic tumors (P &amp;lt;0.001) compared to the BM-negative group. During a median follow-up of 4.2 years, a higher mortality rate was registered in the BM-positive group as compared to BM-negative group (42.3 vs 4.0%, P = 0.001). BMs were more common in patients with lung NETs, G2\u2013G3 grade tumors, and in those with carcinoid syndrome. BMs affected patients\u2019 prognosis, highlighting the importance of investigating and managing this condition in patients with NETs.<\/jats:p>","DOI":"10.1530\/erc-25-0147","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T11:21:58Z","timestamp":1757330518000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":4,"title":["Clinical presentation of bone metastases in neuroendocrine tumors: a retrospective cohort study"],"prefix":"10.1530","volume":"32","author":[{"given":"Elisabetta","family":"Lavezzi","sequence":"first","affiliation":[{"name":"Endocrinology, Diabetology and Medical Andrology Unit, IRCCS, Humanitas Research Hospital 1 , ,","place":["Rozzano, Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Jaafar","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Medical Andrology Unit, IRCCS, Humanitas Research 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Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Elisa","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University 2 , ,","place":["Pieve Emanuele, Milan, Italy"]},{"name":"Gastroenterology Department, IRCCS, Humanitas Research Hospital 5 , ,","place":["Rozzano, Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Cellini","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, University Hospital Santa Maria della Misericordia 3 , ,","place":["Udine, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francesca","family":"Birtolo","sequence":"additional","affiliation":[{"name":"Endocrinology, Diabetology and Medical Andrology Unit, IRCCS, Humanitas Research Hospital 1 , ,","place":["Rozzano, Milan, Italy"]},{"name":"Department of Biomedical Sciences, Humanitas University 2 , ,","place":["Pieve Emanuele, Milan, 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