Helle D Zacho1, Carsten D Mørch2, Tamás Barsi3, Jesper C Mortensen4, Henrik Bertelsen5, Lars J Petersen6. 1. Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Clinical Physiology, Viborg Hospital, Viborg, Denmark. Electronic address: h.zacho@rn.dk. 2. Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. 3. Department of Urology, Viborg Hospital, Viborg, Denmark. 4. Department of Nuclear Medicine, Regional Hospital West Jutland, Herning, Denmark. 5. Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Physiology and Nuclear Medicine, Randers Hospital, Randers, Denmark. 6. Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abstract
OBJECTIVE: To determine the relationship between bone pain and bone metastases in newly diagnosed prostate cancer. PATIENTS AND METHODS: This prospective study of bone scintigraphy enrolled 567 consecutive patients with newly diagnosed prostate cancer. The presence of all-cause bone pain, known benign bone disease, and unexplained bone pain (ie, not related to known benign bone disease) was derived from a patient questionnaire. Univariate logistic regression models (LRMs) were used to assess the relationship between individual clinical variables (all-cause bone pain, unexplained bone pain, prostate-specific antigen, Gleason grade, T stage, and age) and bone metastases. A multivariate LRM was used to assess the relationship between bone metastases and all factors in combination. Agreement between the LRMs and bone metastases was estimated by accuracy and by Cohen's κ. RESULTS: All-cause bone pain predicted bone metastasis in univariate but not multivariate analysis. Unexplained bone pain remained an independent predictor of bone metastases in multivariate analysis (odds ratio: 4.5; P < .001). Prostate-specific antigen was the single most important predictor of bone metastases (P < .001). CONCLUSION: Unexplained bone pain was a strong independent risk factor for bone metastasis. Guidelines should recommend staging bone scintigraphy in patients with unexplained bone pain, regardless of other risk factors.
OBJECTIVE: To determine the relationship between bone pain and bone metastases in newly diagnosed prostate cancer. PATIENTS AND METHODS: This prospective study of bone scintigraphy enrolled 567 consecutive patients with newly diagnosed prostate cancer. The presence of all-cause bone pain, known benign bone disease, and unexplained bone pain (ie, not related to known benign bone disease) was derived from a patient questionnaire. Univariate logistic regression models (LRMs) were used to assess the relationship between individual clinical variables (all-cause bone pain, unexplained bone pain, prostate-specific antigen, Gleason grade, T stage, and age) and bone metastases. A multivariate LRM was used to assess the relationship between bone metastases and all factors in combination. Agreement between the LRMs and bone metastases was estimated by accuracy and by Cohen's κ. RESULTS: All-cause bone pain predicted bone metastasis in univariate but not multivariate analysis. Unexplained bone pain remained an independent predictor of bone metastases in multivariate analysis (odds ratio: 4.5; P < .001). Prostate-specific antigen was the single most important predictor of bone metastases (P < .001). CONCLUSION:Unexplained bone pain was a strong independent risk factor for bone metastasis. Guidelines should recommend staging bone scintigraphy in patients with unexplained bone pain, regardless of other risk factors.
Authors: Randi F Fonager; Helle D Zacho; Niels C Langkilde; Joan Fledelius; June A Ejlersen; Christian Haarmark; Helle W Hendel; Mine Benedicte Lange; Mads R Jochumsen; Jesper C Mortensen; Lars J Petersen Journal: Am J Nucl Med Mol Imaging Date: 2017-11-01
Authors: Lin-Xin Wu; Yan-Peng Dong; Qian-Mei Zhu; Bo Zhang; Bo-Lun Ai; Tao Yan; Guo-Hua Zhang; Li Sun Journal: BMC Cancer Date: 2021-10-20 Impact factor: 4.430