Cintigrafía ósea en pacientes con cáncer de próstata: correlación con aspectos clínicos, de laboratorio y sobrevida / Bone scintigraphy in prostate cancer: correlation with clinical and laboratory features and with survival

RESUMO

Background: The yield of bone scintigraphy is specially good in some types of neoplasia such as mammary and prostate carcinoma, whose metastases cause a marked osteoblastic reaction in bone. Aim: To assess the usefulness of bone scintigraphy in patients with prostate carcinoma. Patients and methods: A retrospective analysis of bone scintigrams performed to 79 patients with prostate carcinoma aged 56 to 83 years old, describing their relationship with prostate specific antigen and bone pain. The predictive value of bone scan, prostate specific antigen and clinical variables was analyzed using Kaplan Meier survival tables. Results: Scintigraphy disclosed bone metastases in 22 patients (28 percent). The most frequently involved zones were pelvis (86 percent), rib cage (67 percent) and spine (57 percent). The association with pain was low specially for limbs, rib cage and skull. The better efficacy of prostate specific antigen for the prediction of bone metastases was obtained with a cutoff value of 50 ng/ml (sensitivity 72 percent, specificity 86 percent). With a cutoff value of 10 ng/ml, the negative predictive value was 100 percent. The only significant predictor of a lower patient survival was the presence of bone metastases on bone scintigraphy. Conclusions: In this series of patients, bone scintigraphy was an excellent diagnostic tool for bone metastases and had a survival prognostic value