Is it safe to omit baseline bone scan for newly diagnosed prostate cancer patients? - Abstract

Objectives: The aim of this study is to modify and validate a novel screening tool to determine the necessity of bone scans in Chinese PCa patients at the time of diagnosis.

Methods: Five-hundred-and-one patients diagnosed with PCa between 2010 and 2013 at Zhongshan Hospital, Fudan University, were included in the study. All received bone scans using technetium 99m methylene diphosphonate (99mTc-​MDP) at the initial staging. Age, prostate-specific antigen (PSA) and alkaline phosphatase (ALP) at diagnosis, disease stage, and biopsy Gleason score were collected from all patients. Multivariate logistic regression analysis and discrimination analysis were performed. A validation analysis of this screening tool was performed by Shanghai Cancer Center, Fudan University.

Results: Among the 501 patients, 84 (16.7%) of them had BM. The area under the ROC curve was 0.9006 (95% CI, 0.87-0.93). The sensitivity of the cut-off point was 94.1%, and the specificity was 58.3%. The validation analysis demonstrated an area under the ROC curve of 0.846 (95% CI, 0.805-0.887).

Conclusions: Study results demonstrated that a baseline bone scan can be safely omitted for cT1-T3 PCa patients who have a PSA ≤ 39 ng/ml and an ALP ≤ 88 IU/l. This novel screening tool may help determine the necessity of including a bone scan at the time of initial diagnosis of PCa.

Written by:
Wang Y, Wan F, Xu L, Zhao N, Xu Z, Wang H, Wang G, Ye D, Guo J.   Are you the author?
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.

Reference: Urol Int. 2015 Jan 29. Epub ahead of print.
doi: 10.1159/000368912

PubMed Abstract
PMID: 25632890 Prostate Cancer Section