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Bone scan positivity in non-metastatic, castrate-resistant prostate cancer: external validation study
Johnston, Ashley W; Longo, Thomas A; Davis, Leah Gerber; Zapata, Daniel; Freedland, Stephen J; Routh, Jonathan C.
  • Johnston, Ashley W; Duke University Medical Center. Division of Urologic Surgery. Durham. US
  • Longo, Thomas A; Duke University Medical Center. Division of Urologic Surgery. Durham. US
  • Davis, Leah Gerber; Duke University Medical Center. Division of Urologic Surgery. Durham. US
  • Zapata, Daniel; Duke University Medical Center. Division of Urologic Surgery. Durham. US
  • Freedland, Stephen J; Cedars-Sinai Medical Center. Division of Urology. Los Angeles. US
  • Routh, Jonathan C; Duke University Medical Center. Division of Urologic Surgery. Durham. US
Int. braz. j. urol ; 46(1): 42-52, Jan.-Feb. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1056364
ABSTRACT
ABSTRACT Introduction: Tables predicting the probability of a positive bone scan in men with non-metastatic, castrate-resistant prostate cancer have recently been reported. We performed an external validation study of these bone scan positivity tables. Materials and Methods: We performed a retrospective cohort study of patients seen at a tertiary care medical center (1996-2012) to select patients with non-metastatic, castrate-resistant prostate cancer. Abstracted data included demographic, anthropometric, and disease-specific data such as patient race, BMI, PSA kinetics, and primary treatment. Primary outcome was metastasis on bone scan. Multivariable logistic regression was performed using generalized estimating equations to adjust for repeated measures. Risk table performance was assessed using ROC curves. Results: We identified 6.509 patients with prostate cancer who had received hormonal therapy with a post-hormonal therapy PSA ≥2ng/mL, 363 of whom had non-metastatic, castrate-resistant prostate cancer. Of these, 187 patients (356 bone scans) had calculable PSA kinetics and ≥1 bone scan. Median follow-up after castrate-resistant prostate cancer diagnosis was 32 months (IQR: 19-48). There were 227 (64%) negative and 129 (36%) positive bone scans. On multivariable analysis, higher PSA at castrate-resistant prostate cancer (4.67 vs. 4.4ng/mL, OR=0.57, P=0.02), shorter time from castrate-resistant prostate cancer to scan (7.9 vs. 14.6 months, OR=0.97, P=0.006) and higher PSA at scan (OR=2.91, P <0.0001) were significantly predictive of bone scan positivity. The AUC of the previously published risk tables for predicting scan positivity was 0.72. Conclusion: Previously published risk tables predicted bone scan positivity in men with non-metastatic, castrate-resistant prostate cancer with reasonable accuracy.
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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Neoplasias Óseas / Neoplasias de la Próstata Resistentes a la Castración Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Anciano / Humanos / Masculino Idioma: Inglés Revista: Int. braz. j. urol Asunto de la revista: Urología Año: 2020 Tipo del documento: Artículo País de afiliación: Estados Unidos Institución/País de afiliación: Cedars-Sinai Medical Center/US / Duke University Medical Center/US

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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Neoplasias Óseas / Neoplasias de la Próstata Resistentes a la Castración Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Anciano / Humanos / Masculino Idioma: Inglés Revista: Int. braz. j. urol Asunto de la revista: Urología Año: 2020 Tipo del documento: Artículo País de afiliación: Estados Unidos Institución/País de afiliación: Cedars-Sinai Medical Center/US / Duke University Medical Center/US