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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On the basis of a series of 89 patients with a histologically confirmed adenocarcinoma of the prostate and another population of 89 patients with prostatic hypertrophy, also confirmed histologically, the authors study the sensitivity and specificity of the radio-immunological estimation of prostatic acid phosphatase levels. Comparison is made of the performance of radio-immunological techniques with that of conventional techniques. As a general rule, the sensitivity of the test is very low, since amongst 39% of the prostatic carcinomas studied, the RI acid phosphatase level was below the upper limit of normal fixed at 3.2 ng/ml. By contrast, the degree of specificity is high, since amongst 96% of cases with abnormally high RI acid phosphatase levels, the diagnosis was indeed an adenocarcinoma of the prostate. In terms of stages, sensitivity was found to be nil for minor stages T1 - T2 and of the order of 80% for advanced stages. This confirmed data from the literature. In the absence of bone metastases detectable radiologically or by isotope bone scan, an abnormally high RI acid phosphatase level is predictive of lymph node involvement in 90% of cases. By contrast, under the same conditions of bone investigations, a normal RI acid phosphatase level corresponds in 81% of cases with absence of lymph node involvement and in 19% with limited involvement. In patients with value which are normal or become normal under the influence of treatment, the prognosis is better than if such does not apply. Finally, figures given by radioimmunological estimation are much more specific than those obtained by traditional enzyme estimations.
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PMID:[Role of prostatic acid phosphatases in the treatment of adenocarcinoma of the prostate]. 620

The low incidence of measurable or evaluable metastases in patients with prostatic cancer makes evaluation of response difficult. This is particularly true in patients with bone metastases only. With a digital model it is possible to measure quantitatively from the radioisotope bone scan the total area of skeletal involvement by metastatic tumor. Definitions of response in bone have been derived from this model. These response criteria have been compared to response in acid phosphatase determinations and clinical status in a study of 44 patients with advanced prostatic cancer treated with estramustine phosphate. Based on serial quantitative bone scans, serial measurements of acid phosphatase levels and repeat clinical evaluations a system is proposed for defining response to systemic therapy that is applicable to the majority of patients with metastatic prostatic cancer.
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PMID:Systemic treatment of advanced prostatic cancer: development of a new system for defining response. 625 76

The technetium methylene diphosphate bone scan was elevated in 100 consecutive new patients presenting with carcinoma of the prostate. 48% of the patients has a positive bone scan at the initial diagnosis. The scan was more helpful than the skeletal X-ray in the diagnosis of bone metastases: 23% of the X-ray-negative patients were scan-positive. Serial bone scans were more sensitive than either X-rays or serum acid phosphatase in following the progress of the disease. It is concluded that the bone scan in patients with prostatic carcinoma can be used as a reliable tumour marker, especially for monitoring the course of metastases.
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PMID:The bone scan as a tumour marker in prostatic carcinoma. 628 89

Response criteria for phase II and phase II trials of prostate carcinoma patients of the EORTC Genito Urinary-Group are described. These criteria, initially closely related to National Prostatic Cancer Project criteria, have gone through a development into the direction of more stringency. Admission of patients to phase II trials is now restricted to those showing objectively measurable lesions, excluding bone metastases. World Health Organization criteria are applied to these patients. For phase III trials, progression to Metastatic TNM system status, time to progression, and duration of survival are recommended as end points. Measurable marker lesions, as for phase II trials and subjective and nonspecific response criteria, are accepted as parameters for progression. Response usually is not evaluated in these studies. Based on recent literature and personal experiences, the author suggests that serum acid phosphatase (SPAP) and volume changes of the primary tumor can be used as indicators for response under certain conditions. There is obviously a great need for further development of objective response criteria for prostatic cancer patients.
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PMID:Treatment response criteria for prostatic cancer. 636 78

Ten patients with prostatic carcinoma--six with stage C and four with stage D disease--were treated for 6 weeks to 12 months with agonistic analogues of luteinizing hormone-releasing hormone (LH-RH). [D-Trp6]LH-RH was given subcutaneously once daily at a dose of 100 microgram and [D-Ser(But)6]des-GlyNH2(10)-LH-RH ethylamide (HOE 766) was given subcutaneously (50 microgram once daily) or intranasally (500 microgram twice daily). In all patients, mean plasma testosterone levels showed a 75% suppression by the third week of treatment and remained low thereafter. This was followed by a decrease or normalization of plasma acid phosphatase levels by the second month of treatment and a 47% decrease in serum alkaline phosphatase by the 10th week of treatment in all but one patient. In patients with stage C disease presenting with prostatism or urinary outflow obstruction, there was a noticeable clinical improvement. In two such patients, a decrease in the size of the prostate was confirmed by ultrasonography. In patients with stage D disease manifested by diffuse bone metastases, there was relief of bone pain, and in one patient treated for greater than 12 months the improvement was documented by radioisotope bone imaging. It is concluded that superactive agonistic LH-RH analogues hold promise as therapeutic agents in patients with androgen-sensitive prostatic adenocarcinoma. Furthermore, the analogous of LH-RH may be used to assess the responsiveness of patients to surgical castration. Long-term administration of LH-RH analogues could become an alternative to surgical castration and estrogen therapy for the treatment of hormone-dependent prostatic carcinoma.
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PMID:Tumor growth inhibition in patients with prostatic carcinoma treated with luteinizing hormone-releasing hormone agonists. 646 61

Bone scintigraphy, serum acid phosphatase activity (ACP), prostatic acid phosphatase by radioimmunoassay (PAP) and alkaline phosphatase activity (ALP) were studied in 117 consecutive patients with prostatic cancer. Serum PAP was more sensitive than ACP in indicating prostatic cancer in the 63 patients with normal bone scans: 28% had positive PAP tests and 15% positive ACP tests. In the 54 patients with bone metastases no difference in the frequency of positive PAP (84%) and ACP (85%) test was observed. Serum PAP and ACP, but not ALP, were useful for the assessment of the response to therapy particularly in patients without bone metastases. In the follow-up of patients with bone metastases the scan was more informative than any of the phosphatase assays studied.
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PMID:Bone scintigraphy and serum phosphatases in the detection and follow-up of bone metastases in prostatic cancer. 649 27

If rectal examination reveals conspicuous palpation findings of the prostate gland, a biopsy must be taken from the corresponding area, because there are no suitable laboratory measures that could help make up a definite diagnosis. Independently from methods, acid phosphatase as well as urine hydroxyprolin show elevated levels only in cases of metastatic formation. Lymphography results are insufficient and inaccurate. Staging lymphadenectomy is the best procedure to evaluate the lymph nodes; because of the relatively high complication rate, however, this operation is only indicated in case of curative treatment. Good results have been achieved through trans-cutaneous fine needle biopsy of the lymph nodes. In order to detect bone metastases, bone-scanning has proved to be valuable. In case of suspicious findings, X-ray procedures must follow in order to reassure the diagnosis. Topical scientific methods are discussed.
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PMID:[Efficient diagnosis of prostate carcinoma]. 661 17

The whole body bone scintigraphy of 13 patients whose prostatic cancer were histologically confirmed, was processed in four colors, and the bone metastases were quantitatively estimated. On the basis of this estimation, the extent of bone metastases was classified into 4 divisions (grades 0, 1, 2 and 3). And then, the correlation between the extent of bone metastases and prostatic acid phosphatase, acid phosphatase, and alkali phosphatase levels in serum were investigated.
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PMID:Correlation between extent of metastatic lesions in whole body bone scintigraphy of patients with prostatic cancer and prostatic acid phosphatase in serum with Eiken PAP RIA kit. 662 97

Of 343 patients who underwent pelvic lymph node dissection during treatment for carcinoma of the prostate 25 had persistently elevated serum enzymatic acid phosphatase levels preoperatively: 15 (60 per cent) had metastases to the pelvic lymph nodes and 10 (40 per cent) had negative nodes. Bone metastases occurred in 10 of 12 (83 per cent) and 5 of 7 patients (71 per cent), respectively, who were followed for a minimum of 2 years. Of the 318 patients with normal serum enzymatic phosphatase levels 70 (22 per cent) had positive nodes. A persistently elevated serum enzymatic acid phosphatase level in patients with proved carcinoma of the prostate, with elimination of infrequent causes of enzyme elevation, indicates metastases and has significant implications regarding staging and, thus, therapy of this disease.
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PMID:Acid phosphatase: its influence on the management of carcinoma of the prostate. 669 Jul 51

Twenty-five patients with metastatic prostate cancer were treated with a combination of Adriamycin 50 mg/m2 and cis-platinum (CDDP) 50 mg/m2 every three weeks. Response was evaluated using radioisotope bone scan, serum acid phosphatase levels, and clinical status. Response rates of 6% bone, 21% acid phosphatase, and 24% clinical status were noted. Major toxicity was gastrointestinal (due to CDDP). Treatment was well tolerated even in patients with extensive bone metastases and prior irradiation. Using the response criteria described here, patients with metastatic prostate cancer without measurable soft tissue disease are eligible for Phase II and III study.
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PMID:A phase II evaluation of adriamycin and cis-platinum in hormone resistant prostate cancer. 720 Aug 27


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