897 IS IT SUITABLE TO ELIMINATE BONE SCAN FOR PROSTATE CANCER PATIENTS WITH PSA ≤20 NG/ML IN KOREAN POPULATION?

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You have accessJournal of UrologyProstate Cancer: Advanced1 Apr 2011897 IS IT SUITABLE TO ELIMINATE BONE SCAN FOR PROSTATE CANCER PATIENTS WITH PSA ≤20 NG/ML IN KOREAN POPULATION? Chan Dong Yeom, Seung Hwan Lee, Mun Su Chung, Kyung Kgi Park, Sang Yol Mah, and Byung Ha Chung Chan Dong YeomChan Dong Yeom Seoul, Korea, Republic of More articles by this author , Seung Hwan LeeSeung Hwan Lee Seoul, Korea, Republic of More articles by this author , Mun Su ChungMun Su Chung Seoul, Korea, Republic of More articles by this author , Kyung Kgi ParkKyung Kgi Park Seoul, Korea, Republic of More articles by this author , Sang Yol MahSang Yol Mah Seoul, Korea, Republic of More articles by this author , and Byung Ha ChungByung Ha Chung Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2606AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Detection of bone metastasis (BM) is important when deciding on the treatment strategy of prostate cancer. According to AUA and EAU guidelines, scanning may not be necessary for those with a serum PSA ≤ 20 ng/mL when they have Gleason scores (GS) ≤ 7. However, it has not been researched that this standard is suitable in Asians whose prostate size or serum PSA are relatively small. Therefore, we evaluated the relationship between bone metastasis and clinical or pathological variables, including the serum PSA concentration. With this evaluation, we tried to determine the clinical profiles of patients for whom bone scanning could be eliminated due to a low probability of bone metastasis. METHODS This retrospective study included 579 consecutive patients with newly diagnosed adenocarcinoma of the prostate who underwent a bone scan study at our institution between 2002 and July 2010. We excluded the patients who had a past history of antiandrogen treatment for benign prostatic hyperplasia or that of other malignant diseases with possible development of BM. We used receiver operating characteristics (ROC) curves to evaluate accuracy of bone metastasis with serum PSA ≤ 20 ng/mL or serum PSA ≤ 10 ng/mL. The diagnostic performance was assessed by calculating the area under the curve (AUC). The statistically significant differences in the AUC were determined using Student¡−s T-test. RESULTS 83/579 men (14.3%) with prostate cancer had a positive bone scan. However, 27/579 men (4.6%) with a serum PSA between 10 and 20 ng/mL, 29/579 men (5.0%) with GS ≤ 7, 21/83 (25.3%) with a serum PSA ≤ 20 ng/mL and GS ≤ 7 had positive bone scans. In the logistic regression analyses, clinical T stage (odds ratio [OR] =3.26; 95% CI, 2.29 to 4.33; p=0.021), GS (OR=3.41; 95% CI, 2.91 to 4.93; p=0.019), and serum PSA (OR=8.37; 95% CI, 3.91 to 19.21; p<0.001) were the predictive factor of detecting the BM. When the serum PSA concentration ≤ 20 ng/mL and GS ≤ 7, the mean sensitivity, specificity, and the area under the curve (AUC) value of bone scans for the detection of BM were 74.7%, 92.9%, and 0.642, respectively (p=0.79; 95% CI, 0.430 to 0.803). When the serum PSA lowered at 10ng/ml and GS ≤ 7, the mean sensitivity, specificity, and the AUC values of bone scans were 100%, 83.9%, and 0.760, respectively (p=0.041; 95% CI, 0.642 to 0.897). CONCLUSIONS Based on our findings, bone scans are necessary in men with a serum PSA between 10 and 20 ng/mL. Different guidelines for eliminating bone scans in newly diagnosed prostate cancer are needed especially in Asians. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e359-e360 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chan Dong Yeom Seoul, Korea, Republic of More articles by this author Seung Hwan Lee Seoul, Korea, Republic of More articles by this author Mun Su Chung Seoul, Korea, Republic of More articles by this author Kyung Kgi Park Seoul, Korea, Republic of More articles by this author Sang Yol Mah Seoul, Korea, Republic of More articles by this author Byung Ha Chung Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...