Validation of contemporary guidelines for bone scintigraphy in prostate cancer staging: A prospective study in patients undergoing radical prostatectomy

Abstract

Objective: The aim of this study was to evaluate, using international urology and oncology guidelines, the criteria for performing bone scintigraphy (BS) in patients with newly diagnosed prostate cancer in a prospective setting with 2 years of follow-up after prostatectomy. Materials and methods: In a prospective setting, criteria from European and US urology and oncology guidelines were evaluated in 220 unselected patients with BS performed as a routine investigation before radical prostatectomy. A prostate-specific antigen level of 0.1 ng/ml or lower after surgery was considered successful and was used as a measure of true-negative BS. Results: Overall, 200 out of 220 patients (91%) experienced successful radical prostatectomy at 6 months, with a 2 year success rate of 83%. The proportion of redundant BS ranged from 56% to 89% among the guidelines, whereas the outcome after radical prostatectomy was 93% within 6 months after surgery and 86–89% after 2 years of follow-up, without significant differences among guideline recommendations. Conclusion: The guidelines from the American Urological Association and the criteria recently published by the present group proposed the largest proportion of redundant BS without compromising patient-related outcome.

Keywords:

• Bone scan
• follow-up after radical prostatectomy
• guidelines
• prostate cancer
• staging

Declaration of interest: The authors declare no conflicts of interest.