Retrospective Study of Predictors of Bone Metastasis in Prostate Cancer Cases

Ho, Christopher Chee Kong; Seong, Poh Keat; Zainuddin, Zulkifli Md; Abdul Manaf, Mohd Rizal; Parameswaran, Muhilan; Razack, Azad H.A.

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자료유형: 학술저널

저자정보: Ho, Christopher Chee Kong (Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre) Seong, Poh Keat (Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre) Zainuddin, Zulkifli Md (Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre) Abdul Manaf, Mohd Rizal (Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre) Parameswaran, Muhilan (Department of Surgery, Universiti Malaya) Razack, Azad H.A. (Department of Surgery, Universiti Malaya)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제14권 제5호

발행연도: 2013.1

수록면: 3,289 - 3,292 (4page)

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Introduction: The purpose of this study was to identify clinical profiles of patients with low risk of having bone metastases, for which bone scanning could be safely eliminated. Materials and Methods: This retrospective cross sectional study looked at prostate cancer patients seen in the Urology Departments in 2 tertiary centres over the 11 year period starting from January 2000 to May 2011. Patient demographic data, levels of PSA at diagnosis, Gleason score for the biopsy core, T-staging as well as the lymph node status were recorded and analysed. Results: 258 men were included. The mean age of those 90 men (34.9%) with bone metastasis was $69.2{\pm}7.3$ years. Logistic regression found that PSA level (P=0.000) at diagnosis and patient's nodal-stage (P=0.02) were the only two independent variables able to predict the probability of bone metastasis among the newly diagnosed prostate cancer patients. Among thowse with a low PSA level less than 20ng/ml, and less than 10ng/ml, bone metastasis were detected in 10.3% (12 out of 117) and 9.7% (7 out of 72), respectively. However, by combining PSA level of 10ng/ml or lower, and nodal negative as the two criteria to predict negative bone scan, a relatively high negative predictive value of 93.8% was obtained. The probability of bone metastasis in prostate cancer can be calculated with this formula: -1.069+0.007(PSA value, ng/ml)+1.021(Nodal status, 0 or 1)=x Probability of bone metastasis=$2.718^x/1+2.718^x$. Conclusion: Newly diagnosed prostate cancer patients with a PSA level of 10ng/ml or lower and negative nodes have a very low risk of bone metastasis (negative predictive value 93.8%) and therefore bone scans may not be necessary.

#Prostate cancer #bone metastasis #bone scan #prostate specific antigen #gleason score

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