Title: Correlation between Serum Prostate Specific Antigen levels with Incidence of Bone Metastases in Newly Diagnosed Prostate Cancer Patients in Indian Population
Authors: Amit Sharma, Sumit Agarwal, MS Chauhan, AK Yadav, Anurag Jain, IP Dubey, Rajeev Kumar, Braj Kishore, MG Vishnoi, Dharmesh Paliwal, Arun Ravi John, Neeraj
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.06
Abstract
Introduction: Prostate cancer is second most frequently diagnosed cancer of men and bone is the commonest site of metastasis in them. There is lack of consensus for the selection criteria for bone scan in low risk patients. Western guidelines do not recommend use of bone scan in asymptomatic patients and in low PSA values. We try to correlate the PSA value with bone metastases through bone scan in Indian population.
Material and Methods: 89 males of histologically proven carcinoma prostate over the period of 15 months, from March 2014 to May 2015 were included in the study. The patients were stratified into 3 groups according to their PSA level: the first group of patients had PSA level ranging from 0 - 10 ng/ml (n = 32), the second group had PSA level ranging from 10.1 - 20 ng/ml (n= 9), the third group had PSA levels > 20 ng/ml (n = 48).
Results: The incidence of osseous metastases proven by bone scintigraphy was found to be 25% (8 out of 32) for PSA level 0 - 10 ng/ml, to 22.2 % (2 out of 9) for PSA level 10.1-20 and 68.7% (33 out of 48) for PSA level > 20 ng/ml (P < 0.001). The incidence of bone metastases < 20ng/ml is 21.73 % (10/46) (table-3). All patients (n=17) with PSA value>100 ng/ml were having bone metastases.
Conclusion: The correlation between PSA value and both presence and metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. Bone scan should be part of initial evaluation in all patients irrespective of serum PSA value as even patients with PSA values< 20 ng/ml are presenting with bone metastases.There should not be any minimal threshold limit of PSA for referring patients to bone scan.
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