title: Percentage of the positive area of bone metastasis is an independent predictor of disease death in advanced prostate cancer.
abstract: We addressed in this study whether quantifying the extent of disease on bone scans can predict the disease death of patients with advanced prostate cancer using computer-assisted image analysis. Pretreatment radionuclide bone scans were reviewed in 56 patients with bone metastases from prostate cancer, and the percentage of the positive area on a bone scan (%PABS) was quantified automatically using a personal computer with the NIH Image program for estimation of the accurate extent of metastatic bone lesions on a bone scan. The significance of the %PABS as well as the other known prognostic factors was evaluated using univariate and multivariate Cox proportional hazards analysis. In univariate regression analysis, the %PABS (P=0.0155), serum alkaline phosphatase (P=0.0272), the tumour grade based on biopsy (P=0.044) and the number of bone lesions on bone scans (P=0.0388) were well associated with disease-specific survival. In multivariate analysis, the %PABS (P=0.0155, relative risk ratio 2.603), but not the other factors, was the independent predictor of the disease death. These results suggest that the %PABS is a novel parameter for predicting the prognosis of patients with advanced prostatic cancer.
authors.affiliation: Department of Urology, Kurume University School of Medicine, Fukuoka, Japan. noguchi@med.kurume-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Noguchi
authors.forename: H
authors.initials: H
authors.lastname: Kikuchi
authors.forename: M
authors.initials: M
authors.lastname: Ishibashi
authors.forename: S
authors.initials: S
authors.lastname: Noda
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000378:metabolism / Q000401:mortality* / Q000556:secondary; D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000401:mortality* / Q000556:secondary; D006801:Humans; D008297:Male; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014055:Tomography, Emission-Computed
chemical_list: D000469:Alkaline Phosphatase; D017430:Prostate-Specific Antigen