Prostate-specific antigen and risk of bone metastases in west Africans with prostate cancer

Abstract

We aimed to assess the relationship between bone scintigraphy findings and prostate-specific antigen (PSA) and Gleason score in a group of treatment naïve West Africans with prostate cancer. The age, PSA, and Gleason scores of 363 patients with prostate cancer were collected. Patients were risk stratified using the D’Amico criteria. Logistic regression was performed to assess the relationship between bone scan results and PSA and Gleason score. Receiver operating characteristics (ROC) analysis was used to determine the diagnostic reliability of the bone scan findings. Ninety of the 96 patients with metastases had high risk, and only 6 had low-to-intermediate risk disease ( P = 0.0001). PSA (odds ratio [OR] 2.4 [95% confidence interval [CI] 1.5–3.8], P = 0.001) and GS (OR 2.2 [95% CI 1.5–3.1], P = 0.001) were independently predictive of the presence of metastases. ROC analysis revealed that PSA predicted the presence of metastases with an area under the curve of 0.72, and using a cut-off value of ≥20 predicted metastases with a sensitivity of 86.5% and specificity of 41.2%. A Gleason score of ≥7 had an 89.6% sensitivity and 34.8% specificity for bone metastases. Using a Gleason cutoff of ≥8, the sensitivity and specificity for predicting bone metastases were 54.2% and 71.5%, respectively. The area under the Gleason score ROC curve was 0.68. PSA and Gleason score are independent predictors of the presence of bone metastases in West Africans with prostate cancer.

Putative Risk Factors of Prostate Cancer in Unscreened Ghanaian Men

“…In the Hsing et al study, 2014, 7.0% were con rmed as prostate cancer by histopathology, a gure consistent with our reported prevalence rate at a cut-off 10 ng/ml. A recent review of hospital-based registry in the study population have reported a prostate cancer incidence of 10.5% per 100,000 men [21]. These ndings agreeing with our ndings demonstrate the diagnostic utility of adjusted PSA cut-off of 10 ng/ml in an unscreened population.…”

Prostate-specific antigen for prediction of skeletal metastases on bone scintigraphy in prostate cancer

“…We were able to show in our study that both serum PSA and Gleason score were able to predict the presence of metastases with reasonable accuracy at 72% and 68%, respectively. [3] We agree with Manohar et al [1] that serum PSA is an independent predictor of bone metastases in patients with prostate cancer. Bone scintigraphy may not be useful as a routine staging investigation, especially in asymptomatic low-to-intermediate risk patients with prostate cancer in resource-limited settings.…”

“…Our group in 2019 published the results of a retrospective study on PSA and the risk of bone metastases in West Africans with prostate cancer in which 96 (26.5%) out of 363 study patients had skeletal metastases on 99m Tc MDP bone scan. [ 3 ] In our study, a PSA cutoff value of ≥20 predicted the presence of skeletal metastases with a sensitivity and specificity of 86.5% and 41.2%, respectively. Although a cutoff value of ≥30 predicted the presence of metastases with a lower sensitivity of 72.9%, the specificity was higher at 56.2%, and 60% of cases were correctly classified.…”

“…We were able to show in our study that both serum PSA and Gleason score were able to predict the presence of metastases with reasonable accuracy at 72% and 68%, respectively. [ 3 ]…”

Value of transrectal contrast-enhanced ultrasound with clinical indicators in the prediction of bone metastasis in prostate cancer

“…In practice, the clinical outcomes of PCa with the same Gleason score and similar histological type are often different. When the Gleason score of ≥8 is used as the cut-off value for predicting bone metastasis of PCa, the sensitivity and specificity are only 54.2% and 71.5%, and the area under the ROC curve is only 0.68 (27). In a patient with PCa bone metastases after radical prostatectomy, the Gleason sum in prostatectomy specimens was not associated with bone scan positivity.…”