“…It has been shown in several studies that the discovery of metastases at diagnosis, is an important factor determining the survival of patients with bone neoplasms (Garza et al, 1999;Zuniga et al, 2005;Yang et al, 2012;Choeprasert et al, 2014;Joo et al, 2015;Muscolo et al, 2015) and this behavior has been associated with various features such as high malignancy (Garza et al, 1999;Yang et al, 2012;Linares-Gonzalez et al, 2014;Joo et al, 2015), local recurrence, (Niu et al, 2012;Li et al, 2015) genetic and hormonal stimuli (Niu et al, 2014;Uribe-Rosales et al, 2014), unconventional age and the anatomical region of the primary tumor (Uribe- Rosales et al, 2014;Joo et al, 2015), history of pathologic fracture due to the primary tumor (Cortes-Rodriguez et al, 2010), no chemotherapy or improper surgical handling (Muscolo et al, 2009) and tumor size (Weber et al, 2002;Yang et al, 2012). In our study, in 2012, increased frequency of metastases at diagnosis was observed; however, to discuss this aspect, we need to collect information on the methods applied for detection of metastases.…”