Do all patients with newly diagnosed prostate cancer need staging radionuclide bone scan? a retrospective study

Al-Ghazo, Mohammed A.; Ghalayini, Ibrahim Fathi; Al-Azab, Rami; Bani-Hani, Ibrahim; Barham, Alaa; Haddad, Yazan

doi:10.1590/s1677-55382010000600006

Cited by 20 publications

(19 citation statements)

References 24 publications

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“…In South Korea, the incidence of prostate cancer is rapidly increasing, ranking fifth among the most common cancers in the male population in 2007 [12]. Therefore, our lower incidence of metastatic Pca compared to previous Asian studies [8, 13] might be due to the increasing awareness of PSA screening in Korea.…”

Section: Discussionmentioning

confidence: 97%

Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL?

et al. 2011

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PurposeWe evaluated the relationship between bone metastasis (BM) and clinical or pathological variables, including the serum prostate-specific antigen (PSA) concentration.MethodsThis retrospective study included 579 consecutive patients with newly diagnosed prostate cancer (Pca) who underwent a bone scan study at our institution between 2002 and 2010. We used receiver operating characteristics curves to evaluate accuracy of bone metastasis between serum PSA 10 and 20 ng/mL.Results A positive bone scan result was found in 83 men (14.3%) with PCa. However, 27 men (4.6%) with serum PSA between 10 and 20 ng/mL, 29/579 men (5.0%) with GS ≤ 7, and 21/83 (25.3%) with serum PSA ≤ 20 ng/mL and Gleason score (GS) ≤ 7 had positive bone scans. In the logistic regression analyses, clinical T stage (odds ratio [OR] = 3.26; 95% CI, 2.29–4.33; P = 0.021), GS (OR = 3.41; 95% CI, 2.91–4.63; P = 0.019), and serum PSA (OR = 8.37; 95% CI, 3.91–19.21; P < 0.001) were predictive factors of detecting the BM. When the serum PSA concentration ≤20 ng/mL and GS ≤ 7, AUC value of bone scans for the detection of BM was 0.640 (P = 0.020; 95% CI, 0.563–0.717). With serum PSA at 10 ng/mL and GS ≤ 7, the AUC values of bone scans were 0.828 (P < 0.001; 95% CI, 0.773–0.883).ConclusionsBone scans might be necessary in men with serum PSA between 10 and 20 ng/mL. New guidelines for eliminating bone scans in patients with newly diagnosed Pca are needed, especially in Asians.

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Section: Discussionmentioning

confidence: 97%

Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL?

et al. 2011

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“…They noted a less than 1% chance of positive results when imaging men with low-risk prostate cancer, data that are consistent in many nations. [50][51][52] Others have reported similar levels of overuse of staging techniques for low-risk prostate cancer, 16,53 despite clear published national guidelines that recommend against such testing protocols. 17,18 We conclude that routine use of CT, MRI, or radionuclide imaging for early-stage, low-risk prostate cancer is not indicated as this approach provides no clinical benefit but is associated with substantial expense.…”

Section: Asco's Top Five List For Oncologymentioning

confidence: 99%

American Society of Clinical Oncology Identifies Five Key Opportunities to Improve Care and Reduce Costs: The Top Five List for Oncology

Schnipper

Smith

Raghavan

et al. 2012

JCO

551

421

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“…in Ritenour et al study 3 , 8% in Mcarthur et al study 4 , 30% in Wymenga et al study 14 , 39, 7% in Al-ghazo et al study 15 .…”

Section: Discussionmentioning

confidence: 90%

The value of Gleason score and prostate-specific antigen level in predicting the need for a baseline nuclear bone scan in patients with newly diagnosed 84 prostate cancer cases

Chorfi

Alaoui

2015

Int J Cancer Ther Oncol

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Conference ProceedingAbstract Purpose: The objective of the present study was to correlate the prostate-specific antigen (PSA) level and Gleason score with the baseline bone scan results in patients with newly diagnosed prostate cancer and try to determine a group of patients whose risk of bone metastases is low enough to omit safely this staging modality. Methods: This retrospective study included 84 consecutive patients with newly diagnosed prostate cancer (Pca) who underwent a staging bone scan in Nuclear Medicine department between August 2013 and August 2014. Data were collected on age, bony pain, prostate-specific antigen (PSA) level and Gleason score, then, bone scan results were analyzed with respect to these parameters. Bone scan was recorded as positive, negative or equivocal. In case of equivocal lesions, a single-photon emission computed tomography combined with computed tomography (SPECT-CT) was performed allowing a better morphological precision. Results: The median age of the patients was 71, 38 years. Bone metastases were detected in 41 patients (49% of cases), bony pain was a reliable presenting sign of skeletal involvement. Both prostate-specific antigen (PSA) level and Gleason score were independent predictors of positive bone scan. However, the combination of these two parameters enhanced predictability of bone scan results. According to this study, the risk to develop a bone metastasis was very low in asymptomatic patients with PSA level < 20 ng/ml irrespective of the Gleason score or with PSA level < 30 ng/ml associated to a Gleason score < 7. Conclusion: The present study discourages the routine use of bone scan as a pre-treatment staging modality in asymptomatic patients with PSA level < 20 ng/ml irrespective of the Gleason score or with PSA level < 30 ng/ml associated to a Gleason score < 7, allowing considerable cost savings and decreasing time from diagnosis to treatment.

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Do all patients with newly diagnosed prostate cancer need staging radionuclide bone scan? a retrospective study

Cited by 20 publications

References 24 publications

Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL?

Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL?

American Society of Clinical Oncology Identifies Five Key Opportunities to Improve Care and Reduce Costs: The Top Five List for Oncology

The value of Gleason score and prostate-specific antigen level in predicting the need for a baseline nuclear bone scan in patients with newly diagnosed 84 prostate cancer cases

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