DOI QR코드

DOI QR Code

Retrospective Study of Predictors of Bone Metastasis in Prostate Cancer Cases

  • 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)
  • 발행 : 2013.05.30

초록

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.

키워드

참고문헌

  1. Abuzallouf S, Dayes I, Lukka H (2004). Baseline staging of newly diagnosed prostate cancer: a summary of the literature. J Urol, 171, 2122-7. https://doi.org/10.1097/01.ju.0000123981.03084.06
  2. Carlin BI, Andriole GL (2000). The natural history, skeletal complications, and management of bone metastases in patients with prostate carcinoma. Cancer, 88, 2989-94. https://doi.org/10.1002/1097-0142(20000615)88:12+<2989::AID-CNCR14>3.0.CO;2-Q
  3. Chybowski FM, Keller JJ, Bergstralh EJ, JOesterling JE (1991). Predicting radionuclide bone scan findings in patients with newly diagnosed, untreated prostate cancer: prostate specific antigen is superior to all other clinical parameters. J Urol, 145, 313-8.
  4. Gleave M, Coupland D, Drachenberg D, et al (1996). Ability of serum prostate-specific antigen levels to predict normal bone scans in patients with newly diagnosed prostate cancer. Urolog, 47, 708-12. https://doi.org/10.1016/S0090-4295(96)80016-1
  5. Gomez P, Manoharan M, Kim SS, Soloway MS (2004). Radionuclide bone scintigraphy in patients with biochemical recurrence after radical prostatectomy: when is it indicated? BJU Int, 94, 299-302. https://doi.org/10.1111/j.1464-410X.2004.04927.x
  6. Groot MT, Boeken Kruger CG, Pelger RC, Uyl-de Groot CA (2003). Costs of prostate cancer, metastatic to the bone, in the Netherlands. Eur Urol, 43, 226-32. https://doi.org/10.1016/S0302-2838(03)00007-1
  7. Heidenreich A, Aus G, Bolla M, et al (2008). EAU guidelines on prostate cancer. Eur Urol, 53, 68-80. https://doi.org/10.1016/j.eururo.2007.09.002
  8. Hirobe M, Takahashi A, Hisasue S, et al (2007). Bone scanning--who needs it among patients with newly diagnosed prostate cancer? Jpn J Clin Oncol, 37, 788-92. https://doi.org/10.1093/jjco/hym097
  9. Hricak H, Choyke PL, Eberhardt SC, Leibel SA, Scardino PT (2007). Imaging prostate cancer: A multidisciplinary perspective. Radiology, 243, 28-53. https://doi.org/10.1148/radiol.2431030580
  10. Huang CY, Hsu HC, Chang CH, Tseng KF, Fong YC (2006). Prostate Cancer with Bone Metastases: A Clinical Profile. Mid Taiwan J Med, 11, 82-9.
  11. Kemp PM, Maguire GA, Bird NJ (1997). Which patients with prostatic carcinoma require a staging bone scan? Br J Urol, 79, 611-4. https://doi.org/10.1046/j.1464-410X.1997.00121.x
  12. Kosuda S, Yoshimura I, Aizawa T, et al (2002). Can initial prostate specific antigen determinations eliminate the need for bone scans in patients with newly diagnosed prostate carcinoma? A multicenter retrospective study in Japan. Cancer, 94, 964-72. https://doi.org/10.1002/cncr.10340
  13. Lai MH, Luk WH, Chan JC (2011). Predicting bone scan findings using sPSA in patients newly diagnosed of prostate cancer: feasibility in Asian population. Urol Oncol, 29, 275-9. https://doi.org/10.1016/j.urolonc.2009.05.007
  14. Lee SH, Chung MS, Park KK, et al (2012). Is it suitable to eliminate bone scan for prostate cancer patients with PSA${\leq}$20 ng/mL? World J Urol, 30, 265-9. https://doi.org/10.1007/s00345-011-0728-6
  15. Lee N, Fawaaz R, Olsson CA, et al (2000). Which patients with newly diagnosed prostate cancer need a radionuclide bone scan? An analysis based on 631 patients. Int J Radiat Oncol Biol Phys, 48, 1443-6. https://doi.org/10.1016/S0360-3016(00)00785-9
  16. Lin K, Szabo Z, Chin BB, Civelek AC (1999). The value of a baseline bone scan in patients with newly diagnosed prostate cancer. Clin Nucl Med, 24, 579-82. https://doi.org/10.1097/00003072-199908000-00007
  17. Moslehi M, Cheki M, Salehi-Marzijarani M, Amuchastegui T, Gholamrezanezhad A (2013). Predictors of bone metastasis in pre-treatment staging of asymptomatic treatment-naïve patients with prostate cancer. Rev Esp Med Nucl Imagen Mol, [Epub ahead of print].
  18. Oesterling JE, Martin SK, Bergstralh EJ, Lowe FC (1993). The use of prostate-specific antigen in staging patients with newly diagnosed prostate cancer. JAMA, 269, 57-60. https://doi.org/10.1001/jama.1993.03500010067033
  19. Rigaud J, Tiguert R, Normand LL, et al (2002). Prognostic value of bone scan in patients with metastatic prostate cancer treated initially with androgen deprivation therapy. J Urol, 168, 1423-6. https://doi.org/10.1016/S0022-5347(05)64465-5
  20. Rudoni M, Antonini G, Favr M, et al (1995). The clinical value of prostate-specific antigen and bone scintigraphy in the staging of patients with newly diagnosed, pathologically proven prostate cancer. Eur J Nucl Med, 22, 207-11. https://doi.org/10.1007/BF01081514
  21. Salonia A, Gallina A, Camerota TC, et al (2006). Bone metastases are infrequent in patients with newly diagnosed prostate cancer: analysis of their clinical and pathologic features. Urology, 68, 362-6. https://doi.org/10.1016/j.urology.2006.02.009
  22. Thompson I, Thrasher JB, Aus G, et al (2007). Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol, 177, 2106-31. https://doi.org/10.1016/j.juro.2007.03.003
  23. Thurairaja R, McFarlane J, Traill Z, Persad R (2004). Stateof-the-art approaches to detecting early bone metastasis in prostate cancer. BJU Int, 94, 268-71. https://doi.org/10.1111/j.1464-410X.2003.04960.x
  24. Wolff JM, Borchers ZH, Wildberger J, Buell U, Jakse G (2000). Is prostate-specific antigen a reliable marker of bone metastasis in patients with newly diagnosed cancer of the prostate? Eur Urol, 33, 376-81.
  25. Zaman MU, Fatima N, Sajjad Z (2011). Metastasis on bone scan with low prostate specific antigen (${\leq}$20 ng/ml) and Gleason's score (<8) in newly diagnosed Pakistani males with prostate cancer: should we follow Western guidelines? Asian Pac J Cancer Prev, 12, 1529-32.

피인용 문헌

  1. Prostatic metastases and polycythemia vera on bone magnetic resonance imaging: A case report pp.1792-1082, 2015, https://doi.org/10.3892/ol.2014.2809
  2. Perineural invasion in prostate biopsy specimens is associated with increased bone metastasis in prostate cancer vol.75, pp.15, 2015, https://doi.org/10.1002/pros.23067