THE CLINICAL-VALUE OF PROSTATE-SPECIFIC ANTIGEN AND BONE-SCINTIGRAPHYIN THE STAGING OF PATIENTS WITH NEWLY-DIAGNOSED, PATHOLOGICALLY PROVEN PROSTATE-CANCER

Recent reports suggest that radionuclide bone scan (BS) may not be nec essary in the standard staging evaluation of patients with prostate ca ncer when serum prostate-specific antigen (PSA) levels are normal. To evaluate the ability of PSA to predict BS findings, we retrospectively reviewed the case records of 118 consecutive patients (median age 73 years, range 50-90 years) with newly diagnosed, untreated, pathologica lly proven prostate cancer who underwent BS and serum PSA sampling wit hin a period of no more than 3 months. Fifty-four out of 118 BSs demon strated metastatic bone disease. A PSA value of less then 10 ng/ml exc luded bone metastasis; of 35 patients with a serum PSA level of 20 ng/ ml or less, seven had a positive BS (negative predictive value of 80%) , These findings provide additional confirmation of the value of low s erum PSA concentrations in excluding the need for a staging BS, althou gh the threshold for a high value of negative predictive accuracy is l ower than previously reported.