Correlation between Low Gleason Score and Prostate Specific Antigen Levels with Incidence of Bone Metastases in Prostate Cancer Patients: When to Omit Bone Scans?

Sanjaya, I. Putu Gde; Mochtar, Chaidir Arif; Umbas, H. Rainy

doi:10.7314/apjcp.2013.14.9.4973

Cited by 17 publications

(19 citation statements)

References 26 publications

(31 reference statements)

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“…The BM cumulative incidence was differently reported from 0.8% to 53.6%. 11 , 15 – 18 The diversity of BM cumulative incidence could be due to various causes: First, most of the prostate patients chose to go to a doctor at an advanced stage in developing countries; Secondly, a high incidence of BM can also be observed in developed countries in the 1990s. 17 , 18 Thus, a metastatic screening for prostate cancer patients should be designed based on local economic development and local epidemiologic characteristics of prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

“… 10 Meanwhile, a series of clinical studies suggested the incidence of BM in prostate patients with low PSA values (<20 ng/mL) is from 12.6% to 36.1%. 11 – 13 A previous study reported, besides PSA, Gleason score can be another predictive factor in prostate cancer patients with BM. 14 More BM risk factors are needed to uncover the clinical metastatic characteristics of prostate cancer, and to supplement the predictive system.…”

Section: Introductionmentioning

confidence: 99%

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The homogeneous and heterogeneous risk factors for the morbidity and prognosis of bone metastasis in patients with prostate cancer

Guo¹,

Zhang²,

Guo³

et al. 2018

CMAR

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Purpose Using the Surveillance, Epidemiology, and End Results database (SEER) to assess the incidence and risk factors of morbidity and prognosis for bone metastases in initial metastatic prostate cancer. Patients and methods The records of 249,331 prostate cancer patients in the SEER database, diagnosed between 2010 and 2014, were obtained were obtained to investigate the risk factors for developing bone metastasis, and the records of 9925 of them who registered before 2013 were retrieved (with at least 1 year follow up) to explore the prognostic factors for bone metastasis. Multivariate logistic and Cox regression were used to identify risk factors and prognostic factors for bone metastases, respectively. Results In total, 12,794 patients (5.1%) were diagnosed with bone metastases at the initial diagnosis. Older age, unmarried status, lymph node metastasis, poor tumor differentiation grade (Gleason grade), metastases at lung, brain, and liver were all positively associated with risk for the morbidity and prognosis of bone metastasis in prostate cancer. Black race and higher T stage were positively associated with bone metastasis development; however, they were not associated with a prognosis of bone metastasis. Conclusion The incidence of bone metastasis in prostate cancer was approximately 5% with poor survival. The prostate cancer has homogeneous and heterogeneous risk factors for incidence and prognosis of bone metastasis, which may provide potential guidelines for the screening and preventive treatment for the bone metastasis of prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The homogeneous and heterogeneous risk factors for the morbidity and prognosis of bone metastasis in patients with prostate cancer

Guo¹,

Zhang²,

Guo³

et al. 2018

CMAR

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“…[1,2] Metastatic disease is often present at the first diagnosis in the clinic, among which bone metastases are the most common sites in PCa, accounting for about 14% of all cases at initial diagnosis. [3] With the occurrence of bone metastases, patients experience bone pain, pathological fracture, and other symptoms that negatively affect their quality of life. [4,5] Worse still, the 5-year survival rate of patients with bone metastases was significantly lower than that of those without bone metastases (3% vs 56%).…”

Section: Introductionmentioning

confidence: 99%

“…[8,9] It should also be noted that prostate-specific antigen (PSA) values were >20 ng/ml in over 90% patients with bone metastatic PCa, which means almost all patients enter the D’Amico high-risk stage when bone metastases are present. [3] Therefore, nomograms based on the equation derived from the regression coefficients of each variable always integrates many prognostic factors may better predict their survival. [10] Unfortunately, noticeable differences and even wholly contrary opinions exist regarding the contribution of some factors in the previous two prognostic models (namely the Indonesian and Japanese models) for patients with bone metastatic PCa, which may lead to confusion among urologists and patients.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a SEER-based prognostic nomogram for patients with bone metastatic prostate cancer

et al. 2019

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Controversies exist between the previous two prognostic nomograms for patients with bone metastatic prostate cancer (PCa), and a nomogram applied to western patients has yet to be established. Thus, we aimed to build a reliable and generic nomogram to individualize prognosis.The independent prognostic factors were identified in a retrospective study of 1556 patients with bone metastatic PCa registered in the Surveillance, Epidemiology and End Results (SEER) database. Besides, the prognostic nomogram was developed using R software according to the result of multivariable Cox regression analysis. Then, the discriminative ability of the nomogram was assessed by analyses of receiver operating characteristic curves (ROC curves). We also performed 1-, 2-, and 3-year calibrations of the nomogram by comparing the predicted survival to the observed survival. Furthermore, the model was externally validated using the data of 711 patients diagnosed at different times enrolled in the SEER database.Age ≥70 years, Gleason score ≥8, PSA value of 201 to 900 ng/ml, stage T4, stage N1, with liver metastases, and Asian/Pacific ethnicity were identified as independent prognostic factors. In the primary cohort, 1-, 2-, and 3-year area under the ROC curve (AUC) of the nomogram for predicting cancer-specific survival (CSS) were 0.71, 0.70, and 0.70, respectively. Besides 1-, 2-, and 3-year AUC were 0.70, 0.68, and 0.69, respectively, in the external validation cohort. Moreover, calibration curves presented perfect agreements between the nomogram-predicted and actual 1-, 2-, and 3-year CSS rate in both the primary and external validation cohorts. In other words, our nomogram has great predictive accuracy and reliability in predicting 1-, 2-, and 3-year CSS for patients with bone metastatic prostate cancer.This study established and validated a prognostic nomogram applied to not only Asian patients but western patients with bone metastatic PCa, which will be useful for patients’ counseling and clinical trial designing.

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“…19 However, other reports have suggested that some patients with low PSA and GS had bone metastasis. 20 Zaman and colleagues 10 identified Asian patients with PSA ≤20 and GS <8 who had bone metastasis and suggested that we should be cautious when adopting Western guidelines for bone scans to an Asian population. The incidence and mortality rate of prostate cancer are lower in Asians than in northern European and Caucasian Americans.…”

Section: Discussionmentioning

confidence: 99%

Application of bone scans for prostate cancer staging: Which guideline shows better result?

Chong

Hwang

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(7-8):e515-9. http://dx.doi.org/10.5489/cuaj.2054 Published online August 11, 2014. AbstractIntroduction: We evaluated the accuracy of current guidelines by analyzing bone scan results and clinical parameters of patients with prostate cancer to determine the optimal guideline for predicting bone metastasis. Methods: We retrospectively analyzed patients who were diagnosed with prostate cancer and who underwent a bone scan. Bone metastasis was confirmed by bone scan results with clinical and radiological follow-up. Serum prostate-specific antigen, Gleason score, percent of positive biopsy core, clinical staging and bone scan results were analyzed. We analyzed diagnostic performance in predicting bone metastasis of the guidelines of the European Association of Urology (EAU), American Urological Association (AUA), and the National Comprehensive Cancer Network (NCCN) guidelines as well as Briganti's classification and regression tree (CART). We also compared the percent of positive biopsy core between patients with and without bone metastases. Results: A total 167 of 806 patients had bone metastases. Receiver operating curve analysis revealed that the AUA and EAU guidelines were better for detecting bone metastases than were Briganti's CART and NCCN. No significant difference was observed between AUA and EAU guidelines. Patients with bone metastases had a higher percent positive core than did patients without metastasis (the cut-off value >55.6). Conclusion:The EAU and AUA guidelines showed better results than did Briganti's CART and NCCN for predicting bone metastasis in the enrolled patients. A bone scan is strongly recommended for patients who have a higher percent positive core and who meet the EAU and AUA guidelines.

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Correlation between Low Gleason Score and Prostate Specific Antigen Levels with Incidence of Bone Metastases in Prostate Cancer Patients: When to Omit Bone Scans?

Cited by 17 publications

References 26 publications

The homogeneous and heterogeneous risk factors for the morbidity and prognosis of bone metastasis in patients with prostate cancer

The homogeneous and heterogeneous risk factors for the morbidity and prognosis of bone metastasis in patients with prostate cancer

Development and validation of a SEER-based prognostic nomogram for patients with bone metastatic prostate cancer

Application of bone scans for prostate cancer staging: Which guideline shows better result?

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