Are staging bone scans necessary in patients with T3a prostate cancer? A multicentre study

Journal article

Danielle Whiting, Simone Giona, Mark Yao, Roa Hassan, Hong Doan, Rustam Karanjia, James Hicks, Ben Eddy, Madaan, S. and Simon Bott 2022. Are staging bone scans necessary in patients with T3a prostate cancer? A multicentre study. Journal of Clinical Urology. https://doi.org/10.1177/20514158221137110
AuthorsDanielle Whiting, Simone Giona, Mark Yao, Roa Hassan, Hong Doan, Rustam Karanjia, James Hicks, Ben Eddy, Madaan, S. and Simon Bott
Abstract

Objective:
Studies reporting increased risk of metastases in T3a disease are based on clinical staging (Digital rectal examination) in the pre-multiparametric–magnetic resonance imaging (MRI) (mp-MRI) era. The aim of our study was to assess the rate of positive bone scans in patients ascribed with T3a prostate cancer on a pre-biopsy mp-MRI.

Methods:
We performed a multicentre, retrospective analysis of all patients with T3a prostate cancer staged by mp-MRI who had a bone scan between January 2017 and April 2020.

Results:
A total of 586 patients were diagnosed with T3a prostate cancer on mp-MRI, with a median age of 71 years (range: 47–87). The median presenting PSA was 11 ng/mL (range: 1–537); 125 patients (21.3%) had a PSA ⩽ 20 and either grade group (GG) 1 or 2 in their prostate biopsy; none of these patients had bone metastases. Eighteen patients (3.1%) were found to have bone metastases: 11 patients had GG ⩾ 3 disease on biopsy and nodal disease, 6 had GG ⩾ 3 without evidence of nodal disease and 1 had a PSA of 103.

Conclusion:
The use of bone scans in patients with T3a prostate cancer staged on mp-MRI but without other evidence of high-risk disease (GG ⩾ 3 and PSA > 20 ng/mL) appears to be unnecessary and could be safely avoided.

Level of evidence:
2b

KeywordsProstat cancer; Staging; Multiparametric–magnetic resonance imaging; Bone scintigraphy; Metastases
Year2022
JournalJournal of Clinical Urology
PublisherSAGE
ISSN2051-4158
2051-4166
Digital Object Identifier (DOI)https://doi.org/10.1177/20514158221137110
Official URLhttps://journals.sagepub.com/doi/full/10.1177/20514158221137110
Publication dates
Online23 Nov 2022
Publication process dates
Deposited10 Aug 2023
Output statusPublished
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Segmental testicular infarction: conservative management is feasible and safe
Sanjeev Madaan, Steven Joniau, Katrien Klockaerts, Liesbeth DeWever, Evelyne Lerut, Raymond Oyen and Hendrik Van Poppel 2008. Segmental testicular infarction: conservative management is feasible and safe. European Urology. 52 (2), pp. 441-445. https://doi.org/10.1016/j.eururo.2007.03.061
Segmental testicular infarction. Conservative management is feasible and safe: part 2
Sanjeev Madaan, Steven Joniau, Katrien Klockaerts, Liesbeth DeWever, Evelyne Lerut, Raymond Oyen and Hendrik Van Poppel 2007. Segmental testicular infarction. Conservative management is feasible and safe: part 2. European Urology. 53 (3), pp. 656-658. https://doi.org/10.1016/j.eururo.2007.03.062
Key clinical issues in renal cancer: a challenge for proteomics
Rosamonde E. Bank, Rachel A. Craven, Patricia Harnden, Sanjeev Madaan, Adrian Joyce and Peter J. Selby 2007. Key clinical issues in renal cancer: a challenge for proteomics. World Journal of Urology. 25, pp. 537-556. https://doi.org/10.1007/s00345-007-0199-y
Unusual squamous cell carcinoma of the scrotum arising from a well healed, innocuous scar of an infertility procedure: a case report
Sanjeev Kotwal, Sanjeev Madaan, Stephen Prescott, Sameer Chilka and Peter Whelan 2007. Unusual squamous cell carcinoma of the scrotum arising from a well healed, innocuous scar of an infertility procedure: a case report. Annals of the Royal College of Surgeons of England. 89 (5), pp. W17-W-19. https://doi.org/10.1308/147870807X188498
Limitations of extracorporeal shock wave lithotripsy
Madaan, S. and Joyce, A. 2007. Limitations of extracorporeal shock wave lithotripsy. Current Opinion in Urology. 17 (2), pp. 109-113. https://doi.org/10.1097/MOU.0b013e32802b70bc
Omental metastasis with malignant ascites: an unusual manifestation of prostatic adenocarcinoma
Sanjeev Madaan, Victor Palit, Patricia Gudgeon and Chandra Shekhar Biyani 2007. Omental metastasis with malignant ascites: an unusual manifestation of prostatic adenocarcinoma. Canadian Urological Association Journal. 1 (3). https://doi.org/10.5489/cuaj.86
Ureteric complications of renal transplantation: the impact of the double J stent and the anterior extravesical ureteroneocystostomy
S. Guleria, R .Chahal, S. Madaan, H. C. Irving, C. G. Newstead, S. G. Pollard and J. P .A. Lodge 2005. Ureteric complications of renal transplantation: the impact of the double J stent and the anterior extravesical ureteroneocystostomy. Transplantation Proceedings. 37 (2), pp. 1054-1056. https://doi.org/10.1016/j.transproceed.2004.12.123
A complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient: a case for conservative management
Rohit Chahal, Sanjeev Madaan, Sandeep Guleria, J Peter A Lodge and John A Spencer 2004. A complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient: a case for conservative management. International Urology and Nephrology. 36, pp. 245-247. https://doi.org/10.1023/b:urol.0000034654.26422.f7
Transplant renal artery kinking: a rare cause of early graft dysfunction
Mohiuddin Miah, Sanjeev Madaan, David J Kessel, Charles G Newstead and Sandeep Guleria 2004. Transplant renal artery kinking: a rare cause of early graft dysfunction. Nephrology Dialysis Transplantation. 19 (7). https://doi.org/10.1093/ndt/gfh152
5-years outcome of a prospective randomised trial to compare Transurethral Electrovaporization of the Prostate (TUVP) to Standard Transurethral Resection (TURP)
Mohamed Y. Hammadeh, Sanjeev Madaan, John Hines and Timothy Philp 2003. 5-years outcome of a prospective randomised trial to compare Transurethral Electrovaporization of the Prostate (TUVP) to Standard Transurethral Resection (TURP). Urology. 61 (6), pp. 1166-1171. https://doi.org/10.1016/S0090-4295(03)00109-2
Androgen-dependent regulation of human MUC1 mucin expression
Stephen Mitchell, Paul Abel, Sanjeev Madaan, James Jeffs, Khurram Chaudhary, Gordon Stamp and El-Nasir Lalani 2002. Androgen-dependent regulation of human MUC1 mucin expression. Neoplasia. 4 (1), pp. 9-18. https://doi.org/10.1038/sj.neo.7900194
Cyclooxygenase-2: a possible target in schistosoma-associated bladder cancer
S.S. El-Sheikh, S. Madaan, A. Alhasso, P. Abel, G. Stamp and E.-N. Lalani 2002. Cyclooxygenase-2: a possible target in schistosoma-associated bladder cancer. BJU International. 88 (9), pp. 921-927. https://doi.org/10.1046/j.1464-4096.2001.01649.x
Genitourinary neurofibromatosis with prostatic involvement
Madaan, S., Hammadeh, S., Thomas, K., Philp, T. and Singh, M. 2001. Genitourinary neurofibromatosis with prostatic involvement. BJU International. 87 (903).
Cytoplasmic induction and over-expression of cyclooxygenase-2 in human prostate cancer: implications for prevention and treatment
S. Madaan, P.D. Abel, K.S. Chaudhary, R. Hewitt, M.A. Stott, G.W.H. Stamp and E.-N. Lalani 2001. Cytoplasmic induction and over-expression of cyclooxygenase-2 in human prostate cancer: implications for prevention and treatment. BJU International. 86 (6), pp. 736-741. https://doi.org/1046/j.1464-410x.2000.00867.x
A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy
Hammadeh, M. Y., Madaan, S., Singh, M. and Philp. T. 2001. A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy. BJU International. 86 (6), pp. 648-651. https://doi.org/10.1046/j.1464-410x.2000.00879.x
Cyclooxygenase-2 in prostate cancer
Madaan, S., Lalani, E-N. and Abel, P. D. 2000. Cyclooxygenase-2 in prostate cancer. Relias Media.
Urethral metastasis from a rectal adenocarcinoma
Madaan, S., Vohra, A. K., Riaz, A. A., Thomas, K. and Philp, T. 2000. Urethral metastasis from a rectal adenocarcinoma. BJU International. 86 (403).
Restorative proctocolectomy for collagenous colitis
Riaz, A. A,, Stirling, R. W., Madaan, S. and Dawson, P. M. 2000. Restorative proctocolectomy for collagenous colitis. Journal of the Royal Society of Medicine. 93 (5), pp. 261-261. https://doi.org/10.1177/014107680009300513