The value of pretreatment clinical and biochemical parameters in staging and prognostic stratification of patients with newly diagnosed prostate carcinoma

Purpose: To determine whether it is possible to select patients in whom and for what reason bone scintigraphy should be performed or not, a retrospective study was performed of 161 consecutive patients with newly diagnosed prostate cancer. Materials and methods: Follow-up varied fron 1 to 88 months during which 67 patients died. Bone scan vere classified from 0 ( normal) to 3 (typical pattern of metastases) and were correlated with age, alkaline phosphatase (AP), prostate specific antigen (PSA), tumor grade, TNM-stage and survival, For survival, 68 patients who were not referred for bone scintigraphy were also evaluated. Results: All parameters demonstrated a correlation with the incidence of a positive bone scan, but PSA was the best overall predictor in this (p 1000 ng/ml and patients with PSA values between 20 and 1000 ng/ml in combination with AP >90 U/L (n=24) had bone metastase Furthermore, a class 3 hone scan was found to be the most important parameter in assessing prognosis and survival (p 1000 ng/ml or less increased levels combined with alkaline phosphatase levels > 90 U/L, bone scintigraphy seems to be of no value in staging disease.