Retrospective study of predictors of bone metastasis in prostate cancer cases

Chee Kong Christopher Ho, Poh Keat Seong, Zulkifli Md. Zainuddin, Mohd Rizal Abdul Manaf, Muhilan Parameswaran, Azad H A Razack

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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±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=2.718x/1+2.718x. 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.

Original languageEnglish
Pages (from-to)3289-3292
Number of pages4
JournalAsian Pacific Journal of Cancer Prevention
Volume14
Issue number5
DOIs
Publication statusPublished - 2013

Fingerprint

Prostatic Neoplasms
Retrospective Studies
Neoplasm Metastasis
Bone and Bones
Neoplasm Grading
Urology
Cross-Sectional Studies
Logistic Models
Lymph Nodes
Demography
Biopsy

Keywords

  • Bone metastasis
  • Bone scan
  • Gleason score
  • Prostate cancer
  • Prostate specific antigen

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Retrospective study of predictors of bone metastasis in prostate cancer cases. / Ho, Chee Kong Christopher; Seong, Poh Keat; Md. Zainuddin, Zulkifli; Abdul Manaf, Mohd Rizal; Parameswaran, Muhilan; Razack, Azad H A.

In: Asian Pacific Journal of Cancer Prevention, Vol. 14, No. 5, 2013, p. 3289-3292.

Research output: Contribution to journalArticle

Ho, Chee Kong Christopher ; Seong, Poh Keat ; Md. Zainuddin, Zulkifli ; Abdul Manaf, Mohd Rizal ; Parameswaran, Muhilan ; Razack, Azad H A. / Retrospective study of predictors of bone metastasis in prostate cancer cases. In: Asian Pacific Journal of Cancer Prevention. 2013 ; Vol. 14, No. 5. pp. 3289-3292.
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AU - Parameswaran, Muhilan

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AB - 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±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=2.718x/1+2.718x. 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.

KW - Bone metastasis

KW - Bone scan

KW - Gleason score

KW - Prostate cancer

KW - Prostate specific antigen

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