title: Prostate cancer metastases to bone: observational study for the evaluation of clinical presentation, course and treatment patterns. Presentation of the METAURO protocol and of patient baseline features.
abstract: OBJECTIVE
  The aim of the present study is to describe the research protocol and preliminary results of an observational survey on presentation patterns of prostate cancer metastasis to bone (METAURO), involving urology departments in several Italian hospitals.
  
  
  METHODS
  The study design was observational and inclusion criteria required subjects with prostate cancer patients who were first diagnosed with metastatic bone disease not more than 18 months before. For each patient recruited to the study, a retrospective evaluation and a prospective surveillance were undertaken.
  
  
  RESULTS
  One hundred and ninety-nine patients were enrolled at 32 urological centers in Italy. The median age of participants at first visit was 72.7 years (SD = 7.8). Mean PSA at onset was 323.6 (SD = 1058.3) and these values strongly correlated with Gleason score (Spearman r = 0.228; p = 0.003). The main cause for suspicion of bone metastasis was routine follow up (53%), followed by pathological fracture (31%). Main metastasis sites were located at femur (43.2%), lumbar sacral spine (39.7%), cervical spine (38.2%) and ribs (33.7%). With regard to the main types of bone metastases identified, 27.6% were sclerotic, 5% were lytic and 21.1% were mixed. The specialist who most frequently suspected bone metastasis and referred patients for diagnostic assessment was an urologist (84.9%).
  
  
  CONCLUSIONS
  The present survey is a multicentric study with the main aim to identify features of prostate cancer patients with bone metastases. This survey confirmed that suspicion of bone metastasis is motivated by pain symptoms only in a small percentage of patients with prostate cancer, which testifies to both the difficulty of diagnosis and the need and usefulness of accurate regular follow up.
authors.affiliation: Azienda Ospedaliera Sant'Anna Como, UO Urologia. giario.conti@auro.it
authors.forename: Giario
authors.initials: G
authors.lastname: Conti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Torre
authors.forename: Virgilio
authors.initials: V
authors.lastname: Cicalese
authors.forename: Gennaro
authors.initials: G
authors.lastname: Micheletti
authors.forename: Maria Giuseppe
authors.initials: MG
authors.lastname: Ludovico
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Vestita
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cottonaro
authors.forename: Carlo
authors.initials: C
authors.lastname: Introini
authors.forename: Massimo
authors.initials: M
authors.lastname: Cecchi
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000556:secondary* / Q000628:therapy; D002985:Clinical Protocols; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D018401:Sample Size; D012959:Socioeconomic Factors