[Does PSA of less than 20 ng/ml exclude the diagnosis of metastatic prostate cancer?].
OBJECTIVE
To demonstrate the considerable risk of bone metastases from clinically localized prostatic cancer with PSA greater than 20 ng/ml.


METHODS
Patients presenting an indication for radical prostatectomy (younger than 70, with localized prostate cancer, less than 6 out of 9 positive biopsies) and PSA less than 20 ng/ml (Tandem) were selected for this intent-to-treat study.


RESULTS
Seven of the 210 patients corresponding to the selection criteria presented with bone metastases and 4 of them had a PSA less than 10 ng/ml. None had lymph node metastases.


CONCLUSIONS
The risk of bone metastases despite PSA less than 20 ng/ml is therefore not negligible. In our opinion, it is necessary therefore to continue to include bone scan in the staging assessment of clinically localized prostate cancer.
Amsellem
D
D
Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
Ogiez
N
N
Salomon
L
L
Chopin
D
D
Abbou
C C
CC
Colombel
M
M
D000368:Aged; D001706:Biopsy; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011877:Radionuclide Imaging; D013997:Time Factors
D017430:Prostate-Specific Antigen