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Bone metastases occur in 2% to 8% of patients following nephrectomy.10,11,14,15 The majority of patients present with symptoms of bone pain (67% to 90%) and with elevated alkaline phosphatase levels (33% to 55%).11,16,17 Furthermore, treatment for bone metastases is usually palliative to prevent pain or pathologic fractures, or to preserve function, and thus routine radiographic surveillance or nuclear scintigraphy is not advocated but used for confirmation of suspected metastases.
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