Biochemical markers of bone turnover are considered useful in the diagnosis and follow-up of patients with malignant bone disease. Although many markers of bone turnover are elevated in patients with established bone metastases, available evidence does not allow any final conclusions to be made regarding the accuracy and validity of these markers for early diagnosis. The diagnostic and prognostic value of bone markers for clinical outcome when used in combination with new diagnostic techniques could pave the way for improvements of clinical assessment, as discussed in this review.
