Raj P Pal1, Thivyaan Thiruudaian, Masood A Khan. 1. Department of Urology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4WP, UK. rppal@doctors.org.uk
Abstract
AIMS: To determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer. METHODS: Between November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value. RESULTS: Only 1/61 men (1.6%) with a serum PSA 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups. CONCLUSION: Based on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA =or< 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis. (c) 2008, Asian Journal of Andrology, SIMM and SJTU. All rights reserved.
AIMS: To determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer. METHODS: Between November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value. RESULTS: Only 1/61 men (1.6%) with a serum PSA 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups. CONCLUSION: Based on our findings, a bone scan is of limited value in asymptomatic prostate cancerpatients presenting PSA =or< 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis. (c) 2008, Asian Journal of Andrology, SIMM and SJTU. All rights reserved.
Authors: Allan Lipton; Robert Uzzo; Robert J Amato; Georgiana K Ellis; Behrooz Hakimian; G David Roodman; Matthew R Smith Journal: J Natl Compr Canc Netw Date: 2009-10 Impact factor: 11.908