Levels of Prostate Specific Antigen that Predict Skeletal Spread in Prostate Cancer

Pantelides, M. L.; Bowman, Susan; George, N. J. R.

doi:10.1111/j.1464-410x.1992.tb06938.x

Cited by 10 publications

(9 citation statements)

References 15 publications

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“…Pantelides et al. also attempted to determine the level of serum PSA that would predict osseous metastasis 8 . Fifty histologically confirmed but untreated prostate cancer patients were carefully monitored with bone scans during a long‐term follow up.…”

Section: Discussionmentioning

confidence: 99%

Prostate‐specific antigen, Gleason sum and clinical T stage for predicting the need for radionuclide bone scan for prostate cancer patients in Japan

Ishizuka¹,

Tanabe²,

Nakayama³

et al. 2005

Int J of Urology

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Aim : In the present study, we evaluated the relationships between prostate-specific antigen (PSA) level and bone metastasis, between Gleason sum and bone metastasis, and between clinical T stage and bone metastasis in Japanese patients. Methods : Between November 1998 and June 2004, we performed ultrasound-guided biopsies on 709 patients (mean age: 70.5 years, range: 39-90). Prostate cancer was detected in 339 patients (47.8%), 297 (87.6%) of whom underwent a radionuclide bone scan. In close collaboration with orthopedists, bone computed tomography scans, bone magnetic resonance imaging and/or plain rentogenograms were performed for cases that were difficult to diagnose as bone metastasis through radionuclide bone scans only. Results : We detected 61 (20.6%) bone metastasis cases in 296 patients. A simple linear regression analysis between log[PSA] and bone metastasis ( n = 296) produced a significant relationship ( P < 0.05). When we set the cut-off PSA value for the indication for a bone scan at 15 ng/mL, the possibility of bone metastasis was 10%. However, from our experience, there was no bone metastasis in the patients whose Gleason sums were less than five, and in the patients whose Gleason sum were five or more, and the PSA levels were less than 15, there was no bone metastasis. The rate of bone metastasis increased with the increase of PSA level. In the clinical T 1 -T 2 stage cases, there were significant higher PSA levels in the cases with bone metastasis. In the T 1 -T 2 patients whose PSA levels were less than 16, there was no bone metastasis. Conclusions : From the analysis of PSA, Gleason sum and clinical T stage, we suggest that bone scan is unnecessary for patients whose PSA level is less than 15 ng/mL or Gleason sum is less than five.

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Section: Discussionmentioning

confidence: 99%

Prostate‐specific antigen, Gleason sum and clinical T stage for predicting the need for radionuclide bone scan for prostate cancer patients in Japan

Ishizuka¹,

Tanabe²,

Nakayama³

et al. 2005

Int J of Urology

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“…Prostate‐specific antigen (PSA) is the most reliable tumor marker of prostate cancer and serum levels of PSA are widely used for diagnosis and monitoring. Because the serum PSA level correlates with extension of prostate cancer, that of M1 prostate cancer is usually remarkably increased, 1–3 but some cases show only a slight increase in serum PSA 4 . We investigated the clinical and pathologic characteristics of M1 prostate cancer with a serum PSA less than 10 ng/mL.…”

Section: Introductionmentioning

confidence: 99%

M1 prostate cancer with a serum level of prostate‐specific antigen less than 10 ng/mL

et al. 2001

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Background: M1 prostate cancer, which is invasive, is usually associated with a serum level of prostate-specific antigen (PSA) greater than 10 ng/mL, but cases are occurring where the serum PSA level is less than this. The present study investigated the clinical and pathologic characteristics of these cases of M1 prostate cancer. Methods: Between April 1989 and March 1998, 167 cases of M1 prostate cancer were diagnosed by transrectal needle biopsy and eight of these with a serum PSA level less than 10 ng/mL were investigated. The patients' ages ranged from 57 to 79 years (median, 73) and the serum PSA levels ranged from less than 4.0 to 9.8 ng/mL. In all cases except one, the distal metastasis was to bones only. All cases had received hormonal therapy as the initial therapy. Immunostaining of PSA, chromogranin A, neuron-specific enolase, carcinoembryonic antigen and vimentin were performed in five of the eight cases. Results: Four cases were poorly differentiated, two were undifferentiated, one was a mixture of poorly differentiated and undifferentiated and one case was moderately differentiated. Of the five cases in the immunohistochemical study, three cases with an undifferentiated carcinoma component showed negative staining reactions for PSA and all cases were positive for carcinoembryonic antigen. Four of the patients died of prostate cancer. In two of these four cases, hormonal therapy was ineffective, but systemic chemotherapy and irradiation therapy had been moderately effective. The overall 3-year survival rate was 33.3%. Conclusions:The cases of M1 prostate cancer with a serum PSA less than 10 ng/mL are almost always poorly differentiated or undifferentiated and have a poor prognosis compared with the usual M1 prostate cancer. Because hormonal therapy is ineffective in these cases, systemic chemotherapy and irradiation therapy should be chosen as the initial therapy.

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“…In 3 patients, PAP anticipated PSA, which, however, increased soon after. Of interest, different from other studies [19], we used a dynamic decision criteria (50% increase between two con secutive samples) instead of a dycotomic cutoff pointbased criteria. The dynamic approach allowed identifica tion of the progression when PSA was still below the cutoff point, providing earlier detection of the progression and improving the diagnostic efficiency of the marker.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, other variables are currently associated with PSA in almost every clinical situation. The additional usefulness of both prostate acid phosphatase (PAP) and bone scan has been previously evaluated [15][16][17][18][19], The majority of published data agree on the fact that PAP is less specific and sensitive than PSA; however, PAP may provide information on disease status in a limited percentage of patients with advanced prostate cancer treated using androgen deprivation [20], being differently regulated than PSA [21,22], A more meaningful problem in the appropriateness of associa tion between PSA and bone scan is that the latter is much more expensive and time-consuming than blood tests.…”

Section: Introductionmentioning

confidence: 99%

Prostate-Specific Antigen as a Unique Routine Test in Monitoring Therapy for Inoperable Prostate Cancer: Comparison with Radionuclide Bone Scan and Prostatic Acid Phosphatase

Barichello¹,

Gion²,

Bonazza³

et al. 1995

Eur Urol

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Levels of Prostate Specific Antigen that Predict Skeletal Spread in Prostate Cancer

Cited by 10 publications

References 15 publications

Prostate‐specific antigen, Gleason sum and clinical T stage for predicting the need for radionuclide bone scan for prostate cancer patients in Japan

Prostate‐specific antigen, Gleason sum and clinical T stage for predicting the need for radionuclide bone scan for prostate cancer patients in Japan

M1 prostate cancer with a serum level of prostate‐specific antigen less than 10 ng/mL

Prostate-Specific Antigen as a Unique Routine Test in Monitoring Therapy for Inoperable Prostate Cancer: Comparison with Radionuclide Bone Scan and Prostatic Acid Phosphatase

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