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

Seung Hwan Lee, Mun Su Chung, Kyung Kgi Park, Chan Dong Yom, Dae Hoon Lee, Byungha Chung

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: We evaluated the relationship between bone metastasis (BM) and clinical or pathological variables, including the serum prostate-specific antigen (PSA) concentration. Methods: This 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%) 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). Conclusions: Bone 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.

Original languageEnglish
Pages (from-to)265-269
Number of pages5
JournalWorld Journal of Urology
Volume30
Issue number2
DOIs
Publication statusPublished - 2012 Apr 1

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Prostate-Specific Antigen
Prostatic Neoplasms
Bone and Bones
Neoplasm Grading
Serum
Neoplasm Metastasis
Odds Ratio
Area Under Curve
ROC Curve
Retrospective Studies
Logistic Models
Regression Analysis
Guidelines

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Lee, Seung Hwan ; Chung, Mun Su ; Park, Kyung Kgi ; Yom, Chan Dong ; Lee, Dae Hoon ; Chung, Byungha. / Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL?. In: World Journal of Urology. 2012 ; Vol. 30, No. 2. pp. 265-269.
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title = "Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL?",
abstract = "Purpose: We evaluated the relationship between bone metastasis (BM) and clinical or pathological variables, including the serum prostate-specific antigen (PSA) concentration. Methods: This 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{\%}) 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). Conclusions: Bone 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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Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL? / Lee, Seung Hwan; Chung, Mun Su; Park, Kyung Kgi; Yom, Chan Dong; Lee, Dae Hoon; Chung, Byungha.

In: World Journal of Urology, Vol. 30, No. 2, 01.04.2012, p. 265-269.

Research output: Contribution to journalArticle

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AU - Lee, Seung Hwan

AU - Chung, Mun Su

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N2 - Purpose: We evaluated the relationship between bone metastasis (BM) and clinical or pathological variables, including the serum prostate-specific antigen (PSA) concentration. Methods: This 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%) 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). Conclusions: Bone 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.

AB - Purpose: We evaluated the relationship between bone metastasis (BM) and clinical or pathological variables, including the serum prostate-specific antigen (PSA) concentration. Methods: This 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%) 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). Conclusions: Bone 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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