1. Incidence of bone metastasis of kidney cancer and its manifestation Kidney cancer is a common malignant tumor in adults, accounting for about 3% of all cancers. 200,000 people worldwide are diagnosed with kidney cancer every year, and about 50,000 people in China have kidney cancer every year, of which about 50% will progress to advanced metastatic kidney cancer. About 33% of kidney cancer has already developed distant metastasis when it is discovered, and 20-40% of patients still have distant metastasis after nephrectomy, and the common sites of metastasis are bone, soft tissue, lung, liver, etc. Bone metastasis of kidney cancer brings great pain to patients, and the common metastatic sites are spine, pelvis and proximal bones of limbs, which often manifest as progressive pain at the lesion site, especially pain at night, and osteolytic bone destruction on X-ray, and pathological fracture and even paraplegia caused by spinal cord compression. 2.Bone metastasis of kidney cancer needs treatment If no intervention is made for bone metastasis of kidney cancer, patients will have unbearable pain and risk of pathological fracture and even paraplegia caused by spinal cord compression. In order to relieve the pain of patients with bone metastasis of kidney cancer, prolong life and improve the quality of survival, patients with bone metastasis of kidney cancer need active comprehensive treatment. 3.Current treatment methods of kidney cancer bone metastasis The current classical treatment plan of kidney cancer bone metastasis is surgical treatment plus immunotherapy. Surgical treatment includes adjuvant nephrectomy and surgical management of bone metastases, aiming at removing the lesions, alleviating patients’ bone pain and preventing pathological fractures and paraplegia. Single bone metastases should be aggressively treated with surgical resection and reconstruction and fixation of the bone defect, including artificial joint replacement, intramedullary pinning and plate fixation, etc. Multiple metastases at risk of pathological fracture should also be aggressively treated with lesion resection, reconstruction and fixation. Scraping and decompression and fixation should be performed for spinal metastatic lesions with the potential for paraplegia. Immunotherapy has more side effects, but it also plays a role in controlling tumor recurrence after surgical resection, which may be beneficial to improve survival rate. 4.Problems of current treatment of kidney cancer bone metastases Current treatment methods have prolonged the survival time of patients with kidney cancer bone metastases, relieved pain after surgical resection and fixation, avoided pathological fracture and paraplegia, and greatly improved the quality of survival. However, recurrence and metastasis to other sites (especially lung metastasis) are still troubling to bone tumor specialists and need to be combined with new treatments to achieve better results. 5. New strategies for treatment of bone metastases from kidney cancer Traditional treatment for bone metastases from kidney cancer has benefited patients, but recurrence and metastases from other sites are still problems that need to be overcome, and oncologists are looking for new treatment strategies. This significant progress has brought new light for bone and soft tissue oncologists to address postoperative recurrence and metastasis to other sites in patients with kidney cancer bone metastases. 6.The revolutionary progress of kidney cancer bone metastasis treatment Targeted therapy refers to the intervention of biological targets such as cell receptors, key genes and regulatory molecules to block the proliferation of tumor, achieve the quiescence or stop the process of tumor development, and promote the apoptosis of tumor cells, which has achieved great success in advanced kidney cancer, gastrointestinal mesenchymal tumor, lymphoma, colorectal cancer, lung cancer and breast cancer. . The targeted therapy drug used for bone metastasis of kidney cancer is sorafenib, trade name Doxorubicin, developed by Bayer and Onyx Pharmaceuticals in Germany, which is a targeted drug approved by FDA (Food and Drug Administration) for advanced renal cell carcinoma and has been marketed in China in November 2006, capable of blocking tumor cell proliferation and tumor angiogenesis at multiple levels, and for patients with metastatic kidney cancer Sorafenib has a significant stabilizing effect on the disease and patients can tolerate long-term daily dosing of the treatment. The largest phase III clinical study of kidney cancer to date has shown that sorafenib significantly prolongs disease-free progression and overall survival in patients with kidney cancer bone metastases, with disease free progression survival twice as long as in the placebo group. The launch of this drug gives bone oncologists and patients a new weapon and will surely have a profound impact on the treatment of bone metastases from kidney cancer. 7. Prospect of kidney cancer bone metastasis treatment The combination of surgery and targeted drug therapy is a new strategy for the treatment of kidney cancer bone metastasis, which will surely lead the treatment of kidney cancer bone metastasis into a new era. Surgery can remove bone metastases and fix them to prevent pathological fractures and paraplegia, while targeted drugs can suppress unresectable metastases and micro-metastases, which can significantly control the progress of the disease and enable patients with kidney cancer bone metastases to achieve long-term tumor-free survival or survival with tumor. Through the unremitting efforts of oncologists and orthopedic specialists, it will be possible to make kidney cancer bone metastases become a chronic disease that can be controlled like hypertension and diabetes, which will be a blessing for kidney cancer bone metastases patients.