Serum alkaline phosphatase is a prognostic marker in bone metastatic disease of the extremity.

PURPOSE: The purpose of this study was to determine the prognostic value of serum alkaline phosphatase for treatment decision making in metastatic bone disease. METHODS: 1090 patients who underwent surgery for extremity metastatic disease were retrospectively identified at two tertiary care centers. The association between alkaline phosphatase and mortality was assessed by bivariate and multivariate analyses. RESULTS: Three-month and one-year mortality rates were 305 (29%) and 639 (62%), respectively. Alkaline phosphatase was associated with mortality at both three months and one year. CONCLUSION: Serum alkaline phosphatase may be a useful marker in prognostic algorithms for patients with extremity metastatic disease.