Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

External beam radiotherapy was administered to 39 patients after radical prostatectomy for adenocarcinoma. Thirty-seven of 39 patients had detectable levels of serum prostate-specific antigen (PSA) prior to irradiation as evidence of residual carcinoma (biochemical evidence of disease). Two patients also had palpable recurrences. Pathologic analysis of the surgical specimens suggested that positive surgical margins, seminal vesicle or lymph node involvement, or high Gleason pattern scores are associated with measurable PSA after surgery. Follow-up ranged from two to seventy-four months (mean 26.8 months). To date, local control has been achieved in all but 1 patient (including 2 patients with palpable tumor prior to radiotherapy). Two distinct risk groups for the development of distant metastases based on the trend of the PSA in relation to the duration of follow-up after radiotherapy are defined. In the high-risk group (those patients with a rising PSA), in 9 of the 18 bone metastases have developed, while none of the 17 low-risk patients have metastatic disease.
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PMID:Serum prostate-specific antigen after post-prostatectomy radiotherapy. 137 76

Bone scintigraphy is the most sensitive imaging technique for the initial detection of bone metastases and is widely used in the staging of prostatic cancer. This study was performed to assess whether the development of further bone metastases can be detected by serial measurements of the serum glycoprotein prostate-specific antigen (PSA) as an alternative to follow-up scintigraphy. The bone scintigrams and PSA levels of 101 patients with metastatic prostate cancer entered into two therapeutic trials have been reviewed. Serial results of both investigations were available in 59 cases. In three cases new bone deposits were observed without a corresponding rise in PSA. In two other cases the scintigrams were considered to be suspicious of progression with no change in PSA levels; however, further follow-up indicated that these changes were not due to metastases. In 13 cases PSA levels were rising in advance of new deposits on the scintigrams. In the remaining 41 cases the PSA levels and scintigraphic findings paralleled each other. We conclude that serial estimation of PSA levels is a simpler marker for disease progression than bone scintigraphy in metastatic prostatic cancer, but that neither technique in isolation gives complete accuracy.
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PMID:Can serum prostate-specific antigen replace bone scintigraphy in the follow-up of metastatic prostatic cancer? 138 17

We report our experience in the follow-up of 63 patients with advanced prostate adenocarcinoma. We used prostate-specific antigen and prostatic acid phosphatase in 27 patients; in 36 patients we evaluated osteocalcin and bone isoenzyme of alkaline phosphatase, two markers of bone metabolism which seem to be good markers in the follow-up of patients with bone metastases.
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PMID:Advanced prostate cancer follow-up with prostate-specific antigen, prostatic acid phosphatase, osteocalcin and bone isoenzyme of alkaline phosphatase. 138 27

We have studied the prognostic significance of prostate-specific antigen (PSA), monitored monthly, in 24 patients with prostatic cancer (5 D1, 19 D2) on endocrine therapy. The pretreatment levels of PSA were high in all patients (mean value 41 ng/ml). It was found that PSA levels at the end of the first and sixth months of treatment were reliable prognostic indicators. At the first month evaluation PSA had decreased more than 50% from the initial values in the 16 patients with stable disease, while it had decreased less than 50% in those with progressing disease. At the end of 6 months, patients with stable disease had PSA levels within the normal range, while 8 of the patients who had progressing disease had levels higher than 10 ng/ml. Respectively 6 and 2 patients had also had increases in PSA levels at 3 and 6 months before scintigraphic demonstration of increased bone metastases.
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PMID:Prognostic significance of prostate-specific antigen in endocrine treatment for prostatic carcinoma. 138 39

To assess the value of serum prostate-specific antigen (PSA) in prostate cancer follow-up, we prospectively studied 107 consecutive patients with: (1) pathologically confirmed prostate cancer; (2) definitive prostatectomy and/or radiation therapy greater than or equal to 3 mo prior to bone scanning; and (3) one bone scan and serum PSA sampling within 3 mo of each other. The mean and range of patient follow-up since definitive therapy was 1.6 and 0.5-8 yr, respectively. Abnormal bone scans were correlated with pertinent radiographs. Of 107 bone scans, 16 demonstrated metastatic bone disease. A PSA value of less than or equal to 8 ng/ml excluded bone metastases with a predictive value of a negative test of 98.5%. Without radiographic correlation, abnormal bone scans rarely represented metastases if the PSA value was less than or equal to 8 ng/ml. In summary, serum PSA concentration determines the need for follow-up bone scanning and assists in scan interpretation in patients status post definitive therapy for prostate cancer.
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PMID:The clinical utility of prostate-specific antigen and bone scintigraphy in prostate cancer follow-up. 171 83

Mucinous adenocarcinoma of the prostate gland is one of the least common morphologic variants of prostatic carcinoma. A lack of precision in the definition of these mucinous neoplasms has resulted in reports which have overstated the incidence of this lesion. Of approximately 1,600 carcinomas of the prostate gland seen at Memorial Hospital from 1963 to 1983, excluding cases with only needle biopsy material, six mucinous prostatic adenocarcinomas were identified. Mucinous prostatic carcinomas were diagnosed when at least 25% of the resected tumor contained lakes of extracellular mucin, and an extraprostatic tumor site was ruled out. In five of the six cases, a cribriform pattern predominated in the mucinous areas. All of the mucinous prostatic tumors had prostate-specific acid phosphatase (PSAP) and prostate-specific antigen (PSA) immunoreactivity. Our experience and our review of the literature indicate that these tumors do not respond well to hormonal therapy. Contrary to prevalent opinion, they have an aggressive biologic behavior and, like nonmucinous prostate carcinomas, have a propensity to develop bone metastases and increased serum acid phosphatase levels with advanced disease.
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PMID:Mucinous adenocarcinoma of the prostate gland. 240 26

We identified 26 cases of metastatic prostatic carcinoma in supradiaphragmatic lymph nodes from 1972-1987. All involved nodes (15 supraclavicular, eight cervical, two axillary, and one mediastinal) were taken from the left side. Of those cases with available data, serum acid phosphatase was normal in five of 21 (24%). Seven of 20 (35%) had no evidence of bone metastases. Rectal examination was normal in eight of 19 cases (42%). While seven cases had a history of prostate cancer, the rest presented with enlarged nodes alone or with simultaneous urinary obstructive symptoms. Eighteen patients died following node biopsy (mean 19.8 months, range 1-46 months). Twenty-two of 26 metastases were high grade and often were not histologically suggestive of prostate carcinoma. In general, immunohistochemical staining for prostate-specific acid phosphatase (PSAP) was more intense than for prostate-specific antigen (PSA), in contrast to several other reports using these antisera. Metastatic prostate carcinoma should be ruled out by using immunoperoxidase for PSA and PSAP in all men over 45 presenting with carcinoma of unknown primary origin in left-sided supradiaphragmatic lymph nodes, even in the absence of bony disease, elevated serum acid phosphatase (SAP), abnormal rectal examination, and a histologic picture suggesting prostate carcinoma.
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PMID:Metastatic prostatic carcinoma to supradiaphragmatic lymph nodes. A clinicopathologic and immunohistochemical study. 243 55

Prostate-specific antigen (PSA) was compared to prostatic acid phosphatase (PAP) in patients with prostatic cancer suspected to have bone metastases. Bone scans were classified according to metastatic skeletal involvement. The sensitivity of PSA in predicting the presence of metastatic disease (68%) was better than that of PAP (53%). Specificity was 79% for PSA and 90% for PAP. Thirty-five patients had a positive PSA level and a normal scintigraphy (false-positive); 14 of them had only endoscopic prostate resection. Thirty-eight patients underwent a further exploration 3-18 months later. PSA level during disease was correlated to scintigraphy in 32 of 38 patients.
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PMID:Systematic association of PAP and PSA determinations to bone scintigraphy in prostatic cancer. 246 77

For an evaluation of the clinical utility of prostate-specific antigen (PSA), 32 prostatic carcinoma patients (ages 54-76) and 13 nonprostatic carcinoma patients (ages 60-70) underwent PSA measurements and bone imaging. At the time of bone imaging, each patient's PSA value was measured by a monoclonal immunoradiometric assay. All 13 nonprostatic carcinoma patients (11 bronchogenic, 1 colon, and 1 urinary bladder) gave normal PSA values, although 6 had metastatic bone disease. The 32 prostatic cancer patients were divided into 2 groups of 16 each; PSA levels in Group 1 were abnormal (greater than or equal to ng/ml): PSA levels in Group 2 were normal (less than 4 ng/ml). In Group 1, bone images of 14 patients showed bone metastases; 6 of the 14 showed progression of metastases in a 6- to 12-month period. Two patients in Group 1 were negative for skeletal metastases. Twelve patients in Group 2 were negative for skeletal metastases; bone imaging in 1 showed regression of skeletal metastases; and 3 patients had unchanged bone lesion(s). The data indicate that PSA measurements may enhance bone imaging interpretation and provide valuable clinical monitoring of prostatic carcinoma. In the case of a patient with positive bone imaging and an unknown primary, PSA measurements may definitively determine if metastases originated from prostatic carcinoma.
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PMID:Correlation of prostate-specific antigen and technetium-99m HMDP bone imaging. 247 31

Response of prostatic cancer bone metastases to therapy (androgen withdrawal and Estracyt) was studied in 43 patients by applying scintiscanning and radioimmunodetective measurement of serum osteocalcin (OC) values. The prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) concentrations, as sensitive probes for the overall tumor spread, were used in parallel in a monitoring procedure. A significant rise in OC levels to values elevated from a pretreatment normal level has been found in patients with a partial osseous tumor remission, and this may be easily distinguished from normal and/or subnormal OC level in bony tumor progression (P less than 0.01) and during stabilization in metastatic spread (P less than 0.01). On these bases, differences between disease progression and the "no change" response category could not be statistically recognized (P greater than 0.05). A sharp increase in circulating OC level has been recorded 1 months after the beginning of the treatment leading to bone remodeling processes and precedes improvements in scintiscan appearance. Blood OC concentration seems also to be of utility 1) in distinguishing scintigraphic flare phenomenon from a slight bone scan progression and 2) when related to scans with regions of both disease improvement and worsening. Furthermore, serum OC concentration can frequently be measured through a noninvasive procedure, thus serving as a significant addition to bone scintigraphy.
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PMID:Correlation between bone scans and serum levels of osteocalcin, prostate-specific antigen, and prostatic acid phosphatase in monitoring patients with disseminated cancer of the prostate. 247 38


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