Independent predictors of bone metastases at the initial stage of prostate cancer diagnosis: A single center analysis in Chinese patients
10.16781/j.0258-879x.2016.01.0005
- Author:
Liang TANG
1
Author Information
1. Department of Urology, Changhai Hospital, Second Military Medical University
- Publication Type:Journal Article
- Keywords:
Bone metastasis;
Prostate-specific antigen\;
Prostatic neoplasms;
Risk factors
- From:
Academic Journal of Second Military Medical University
2016;37(1):5-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective To indentify the high risk factors of bone metastasis in Chinese patients at the initial stage of prostate cancer (PCa) diagnosis, so as to elucidate the characteristics of patients with very low risk of bone metastasis at the initial stage of prostate cancer. Methods A consecutive series of 496 patients with newly diagnosed PCa between 2010 and 2015 were enrolled in the present study. All the patients were subjected to ECT scan for presence of bone metastasis (BM) using total-body 99mTc MDP scintigraphy regardless of baseline PCa characteristics. Factors including the age of diagnosis, prostate specific antigen (PSA) level at diagnosis, Gleason score, clinical T stage, bone scan and CT/MRI results were analyzed. Univariate and multivariate logistic regression analyses were performed to identify the predictors of bone metastases. Results Of the 496 patients, 81 patients (16.3%) had bone metastases. The PSA levels of patients with BM were significantly higher than those without BM (P<0.001). The mean age of the patients with BM was not significantly older than that of the patients without BM. Patients with higher PSA level, clinical T stage or Gleason score showed a significantly higher risk of BM (P<0.001). Univariate logistic regression analysis showed that PSA>20 ng/mL at diagnosis, clinical stage at T3-T4 and Gleason score≥8 were the risk factors of bone metastasis in PCa patients. The multivariate analysis showed that the PSA level>50 ng/mL and the Gleason score≥8 were the independent predictors of bone metastases. No bone metastasis was found in 79 patients with PSA≤20 ng/mL and at the same time with Gleason score≤6. Conclusion The bone metastases rate is very low in Chinese patients with a PSA level ≤20 ng/mL and at the same time with Gleason score≤6, so a bone scan is not necessary as a routine for these patients with newly diagnosed prostate cancer.
