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Practice patterns and predictors of followup imaging after a negative bone scan in men with castration resistant prostate cancer: results from the SEARCH database.

Publication ,  Journal Article
Sourbeer, KN; Howard, LE; Moreira, DM; Amarasekara, HS; Chow, LD; Cockrell, DC; Hanyok, BT; Pratson, CL; Kane, CJ; Terris, MK; Aronson, WJ ...
Published in: The Journal of urology
April 2015

We investigated imaging practice patterns in men with nonmetastatic (M0) castration resistant prostate cancer.We analyzed data on 247 patients with documented M0 CRPC from the SEARCH database. Patients were selected regardless of primary treatment modality and all had a negative bone scan after a castration resistant prostate cancer diagnosis. Cox models were used to test associations of time to a second imaging test with several demographic and clinical factors.During a median followup of 29.0 months (IQR 12.9-43.5) after a post-castration resistant prostate cancer bone scan was negative, 190 patients (77%) underwent a second imaging test. On univariable analysis patients with higher prostate specific antigen (HR 1.13, p = 0.016), shorter prostate specific antigen doubling time (HR 0.79, p < 0.001) and faster prostate specific antigen velocity (HR 1.01, p < 0.001) were more likely to undergo a second imaging test. Treatment center was also a significant predictor of a second imaging test (p = 0.010). No other factor was a significant predictor. Results were similar on multivariable analysis. It was estimated that approximately 20% of men with a prostate specific antigen doubling time of less than 3 months did not undergo an imaging test in the first year after a post-castration resistant prostate cancer negative bone scan. However, 50% of patients with prostate specific antigen doubling time 15 months or greater underwent a second imaging test in the first year.Clinicians use some known predictors of positive imaging tests to determine which patients with M0 castration resistant prostate cancer undergo a second imaging test . However, there may be under imaging in those at high risk and over imaging in those at low risk. Further studies are needed to identify risk factors for metastasis and form clear imaging guidelines in patients with M0 castration resistant prostate cancer.

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Published In

The Journal of urology

DOI

EISSN

1527-3792

ISSN

0022-5347

Publication Date

April 2015

Volume

193

Issue

4

Start / End Page

1232 / 1238

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Radionuclide Imaging
  • Prostatic Neoplasms, Castration-Resistant
  • Prostate-Specific Antigen
  • Practice Patterns, Physicians'
  • Male
  • Humans
  • Forecasting
  • Follow-Up Studies
 

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Sourbeer, K. N., Howard, L. E., Moreira, D. M., Amarasekara, H. S., Chow, L. D., Cockrell, D. C., … Freedland, S. J. (2015). Practice patterns and predictors of followup imaging after a negative bone scan in men with castration resistant prostate cancer: results from the SEARCH database. The Journal of Urology, 193(4), 1232–1238. https://doi.org/10.1016/j.juro.2014.11.014
Sourbeer, Katharine N., Lauren E. Howard, Daniel M. Moreira, Hiruni S. Amarasekara, Lydia D. Chow, Dillon C. Cockrell, Brian T. Hanyok, et al. “Practice patterns and predictors of followup imaging after a negative bone scan in men with castration resistant prostate cancer: results from the SEARCH database.The Journal of Urology 193, no. 4 (April 2015): 1232–38. https://doi.org/10.1016/j.juro.2014.11.014.
Sourbeer KN, Howard LE, Moreira DM, Amarasekara HS, Chow LD, Cockrell DC, et al. Practice patterns and predictors of followup imaging after a negative bone scan in men with castration resistant prostate cancer: results from the SEARCH database. The Journal of urology. 2015 Apr;193(4):1232–8.
Sourbeer, Katharine N., et al. “Practice patterns and predictors of followup imaging after a negative bone scan in men with castration resistant prostate cancer: results from the SEARCH database.The Journal of Urology, vol. 193, no. 4, Apr. 2015, pp. 1232–38. Epmc, doi:10.1016/j.juro.2014.11.014.
Sourbeer KN, Howard LE, Moreira DM, Amarasekara HS, Chow LD, Cockrell DC, Hanyok BT, Pratson CL, Kane CJ, Terris MK, Aronson WJ, Cooperberg MR, Amling CL, Hernandez RK, Freedland SJ. Practice patterns and predictors of followup imaging after a negative bone scan in men with castration resistant prostate cancer: results from the SEARCH database. The Journal of urology. 2015 Apr;193(4):1232–1238.
Journal cover image

Published In

The Journal of urology

DOI

EISSN

1527-3792

ISSN

0022-5347

Publication Date

April 2015

Volume

193

Issue

4

Start / End Page

1232 / 1238

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Radionuclide Imaging
  • Prostatic Neoplasms, Castration-Resistant
  • Prostate-Specific Antigen
  • Practice Patterns, Physicians'
  • Male
  • Humans
  • Forecasting
  • Follow-Up Studies