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Bone scan positivity in non-metastatic, castrate-resistant prostate cancer: external validation study.

Publication ,  Journal Article
Johnston, AW; Longo, TA; Davis, LG; Zapata, D; Freedland, SJ; Routh, JC
Published in: Int Braz J Urol
2020

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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Published In

Int Braz J Urol

DOI

EISSN

1677-6119

Publication Date

2020

Volume

46

Issue

1

Start / End Page

42 / 52

Location

Brazil

Related Subject Headings

  • Urology & Nephrology
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Reference Values
  • ROC Curve
  • Prostatic Neoplasms, Castration-Resistant
  • Prostate-Specific Antigen
  • Predictive Value of Tests
 

Citation

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MLA
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Johnston, A. W., Longo, T. A., Davis, L. G., Zapata, D., Freedland, S. J., & Routh, J. C. (2020). Bone scan positivity in non-metastatic, castrate-resistant prostate cancer: external validation study. Int Braz J Urol, 46(1), 42–52. https://doi.org/10.1590/S1677-5538.IBJU.2019.0225
Johnston, Ashley W., Thomas A. Longo, Leah Gerber Davis, Daniel Zapata, Stephen J. Freedland, and Jonathan C. Routh. “Bone scan positivity in non-metastatic, castrate-resistant prostate cancer: external validation study.Int Braz J Urol 46, no. 1 (2020): 42–52. https://doi.org/10.1590/S1677-5538.IBJU.2019.0225.
Johnston AW, Longo TA, Davis LG, Zapata D, Freedland SJ, Routh JC. Bone scan positivity in non-metastatic, castrate-resistant prostate cancer: external validation study. Int Braz J Urol. 2020;46(1):42–52.
Johnston, Ashley W., et al. “Bone scan positivity in non-metastatic, castrate-resistant prostate cancer: external validation study.Int Braz J Urol, vol. 46, no. 1, 2020, pp. 42–52. Pubmed, doi:10.1590/S1677-5538.IBJU.2019.0225.
Johnston AW, Longo TA, Davis LG, Zapata D, Freedland SJ, Routh JC. Bone scan positivity in non-metastatic, castrate-resistant prostate cancer: external validation study. Int Braz J Urol. 2020;46(1):42–52.

Published In

Int Braz J Urol

DOI

EISSN

1677-6119

Publication Date

2020

Volume

46

Issue

1

Start / End Page

42 / 52

Location

Brazil

Related Subject Headings

  • Urology & Nephrology
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Reference Values
  • ROC Curve
  • Prostatic Neoplasms, Castration-Resistant
  • Prostate-Specific Antigen
  • Predictive Value of Tests