Open AccessWhen is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer?
Author(s) -
Pal Raj P.,
Thiruudaian Thivyaan,
Khan Masood A.
Publication year - 2008
Publication title -
asian journal of andrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 74
eISSN - 1745-7262
pISSN - 1008-682X
DOI - 10.1111/j.1745-7262.2008.00427.x
Subject(s) - medicine , rectal examination , prostate cancer , asymptomatic , prostate specific antigen , urology , bone metastasis , logistic regression , prostate , biopsy , univariate analysis , cancer , multivariate analysis , radiology
Aims: To determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer. Methods: Between November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate‐specific antigen (PSA) cut‐offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value. Results: Only 1/61 men (1.6%) with a serum PSA ≤ 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1–40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1–60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1–100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups. Conclusion: Based on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA ≤ 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.