EXTENT OF DISEASE BASED ON INITIAL BONE-SCAN - IMPORTANT PROGNOSTIC PREDICTOR FOR PATIENTS WITH METASTATIC PROSTATIC-CANCER - EXPERIENCE FROM THE SCANDINAVIAN PROSTATIC-CANCER GROUP-STUDY NO-2 (SPCG-2)

The skeleton is the most frequent site of metastases from prostate can cer. Quantitation of the amount of tumor burden has a great prognostic value and is of importance for clinical trials. The present study rev iews 194 bone scans from the SPCG-2 study which consisted of 294 patie nts entered into a randomized prospective multicenter trial, comparing total androgen suppression with standard treatment in patients with m etastatic prostatic cancer (orchiectomy plus cyproterone acetate vs. o rchiectomy plus placebo). Evaluation of the initial bone scans based o n the extension of the disease (EOD) as proposed by Soloway and associ ates gives a convenient stratification of the patients. With regard to time to progression and cancer-related as well as overall survival, t his EOD grading system had a significant prognostic value (p < 0.001). There was no statistical difference between the two treatment arms in the different categories of the EOD grading system with regard to tim e to progression and time to death. By analyzing exclusively the subgr oup of patients with minimal disease (EOD I) and good performance stat us (WHO score 0), there was a nonsignificant trend towards a better 2- year progression-free survival as well as a better 2-year cancer-relat ed survival for those who were subjected to total androgen suppression as compared with the patients subjected to the standard treatment (or chiectomy).