PATTERNS OF BONE METASTASIS AND THEIR PROGNOSTIC-SIGNIFICANCE IN PATIENTS WITH CARCINOMA OF THE PROSTATE

The different patterns of bone metastasis, metastatic load and their p rognostic significance were examined in a consecutive series of 169 me n with prostatic cancer and bone metastasis at presentation. Patients with an isolated metastasis in the pelvis or dorsal vertebrae had a be tter prognosis than those whose metastases were either diffuse or invo lved more distal sites such as the skull or the sternum, although all of these patients were classified as having M1 disease. Bone metastasi s involving an area equivalent to 1 vertebral body equalled a metastat ic load of 2. Based on their total metastatic load, 3 prognostic group s were identified with significant differences in case-specific surviv al despite receiving the same hormonal treatment. When comparing the p otential efficacy of various treatments one must stratify the metastat ic load, which is a powerful prognostic indicator of the outcome in pa tients with metastatic carcinoma of the prostate.