Prostate Cancer with Bone Metastases: A Clinical Profile

前列腺癌合併骨轉移：臨床表現

黃俊寅(Chun-Yin Huang) ； 許弘昌(Horng-Chaung Hsu) ； 張兆祥(Chao-Hsian Chang) ； 曾國峰(Kuo-Fung Tseng) ； 馮逸卿(Yi-Chin Fong)

《Mid-Taiwan Journal of Medicine》 11卷2期 (2006/06) Pp. 82-89

https://doi.org/10.6558/MTJM.2006.11(2).2

摘要

Purpose. Metastasis to bone commonly causes high morbidity and mortality rates in patients with advanced prostate cancer. Prostate-specific antigen (PSA) and bone scans are important modalities for evaluating and following the disease progression. We reviewed clinical symptoms, laboratory data, treatment and prognosis in order to analyze patients with bone-metastasized prostate cancer.
Methods. From January 1995 to December 2003, a total of 284 patients with prostate cancer were admitted to the China Medical University Hospital; of them, 97 patients were diagnosed as having bone metastases. The clinical files of the 97 patients with bone metastases were reviewed. The patients were categorized into two groups: group 1 comprised those in whom primary prostate cancer and bone metastases were identified simultaneously; group 2 was composed of those with bone metastases found after identification and treatment of prostate cancer.
Results. Bone metastasis was found in 34.2% (97/284 patients) of prostate cancer patients. Of the 97 patients with bone metastasis, the mean age was 71.5 years (range, 49 to 89 years) when prostate cancer was first diagnosed. Axial bones were more affected than appendicular bones. At the time bone metastasis was diagnosed, 69 patients (71.1%) had bone pain, 28 patients (28.8%) were asymptomatic and 6 patients in group 1 and 7 patients in group 2 had a serum PSA value less than 10ng/mL. Four patients underwent surgical treatment for their pathological femoral fracture, resulting in good pain relief. The survival rate after bone metastasis had developed was not statistically significant between groups 1 and 2 (p＞0.05). Of the 3 factors being examined, the age at diagnosis of prostate cancer, the PSA value at first positive bone scan, and initial location and number of bone metastases did not statistically affect the survival rate in these two groups (p＞0.05).
Conclusions. A serum PSA level≥10ng/mL is an important marker in the metastatic work-up of prostate cancer; however bone metastases cannot be ruled out in patients with a serum PSA value of less than 10ng/mL. There was no difference in the survival rate between untreated and treated prostate cancer patients with bone metastases. The age of the patient, the initial PSA value and the location of bone metastases did not appear to affect the outcome of the disease.

關鍵字

骨轉移 ； 前列腺癌 ； 攝護腺特異性抗原

並列摘要

Purpose. Metastasis to bone commonly causes high morbidity and mortality rates in patients with advanced prostate cancer. Prostate-specific antigen (PSA) and bone scans are important modalities for evaluating and following the disease progression. We reviewed clinical symptoms, laboratory data, treatment and prognosis in order to analyze patients with bone-metastasized prostate cancer.
Methods. From January 1995 to December 2003, a total of 284 patients with prostate cancer were admitted to the China Medical University Hospital; of them, 97 patients were diagnosed as having bone metastases. The clinical files of the 97 patients with bone metastases were reviewed. The patients were categorized into two groups: group 1 comprised those in whom primary prostate cancer and bone metastases were identified simultaneously; group 2 was composed of those with bone metastases found after identification and treatment of prostate cancer.
Results. Bone metastasis was found in 34.2% (97/284 patients) of prostate cancer patients. Of the 97 patients with bone metastasis, the mean age was 71.5 years (range, 49 to 89 years) when prostate cancer was first diagnosed. Axial bones were more affected than appendicular bones. At the time bone metastasis was diagnosed, 69 patients (71.1%) had bone pain, 28 patients (28.8%) were asymptomatic and 6 patients in group 1 and 7 patients in group 2 had a serum PSA value less than 10ng/mL. Four patients underwent surgical treatment for their pathological femoral fracture, resulting in good pain relief. The survival rate after bone metastasis had developed was not statistically significant between groups 1 and 2 (p＞0.05). Of the 3 factors being examined, the age at diagnosis of prostate cancer, the PSA value at first positive bone scan, and initial location and number of bone metastases did not statistically affect the survival rate in these two groups (p＞0.05).
Conclusions. A serum PSA level≥10ng/mL is an important marker in the metastatic work-up of prostate cancer; however bone metastases cannot be ruled out in patients with a serum PSA value of less than 10ng/mL. There was no difference in the survival rate between untreated and treated prostate cancer patients with bone metastases. The age of the patient, the initial PSA value and the location of bone metastases did not appear to affect the outcome of the disease.

並列關鍵字

bone metastases ； prostate cancer ； PSA