The role of vertebral veins in the dissemination of prostatic carcinoma.

The concept that the vertebral system of veins acts as a direct conduit in the spread of prostatic carcinoma to the skeletal system is based on the poorly documented observation that this tumor metastasizes preferentially to the pelvis, lumbar spine and sacrum. We analyzed 99mtechnetium bone scans in patients with skeletal metastases from assorted primary tumors and found that the distribution of metastases was virtually identical in patients with prostatic and nonprostatic tumors. Of the patients with prostatic carcinoma 25 per cent had bone scan lesions exclusively outside the region of the sacrum, pelvis and lumbar spine. The distribution of skeletal metastases from prostatic carcinoma does not support the concept that the vertebral veins have a substantial role in the dissemination of this tumor.