Does PSA of less than 20 ng/ml exclude the diagnosis of metastatic prostate cancer?
Amsellem, D.; Ogiez, N.; Salomon, L.; Chopin, D.; Abbou, C.C.; Colombel, M.
Progres en Urologie Journal de l'Association Francaise d'Urologie et de la Societe Francaise d'Urologie 8(6): 1018-1021
1998
ISSN/ISBN: 1166-7087 PMID: 9894261 Document Number: 486564
To demonstrate the considerable risk of bone metastases from clinically localized prostatic cancer with PSA greater than 20 ng/ml. Patients presenting an indication for radical prostatectomy (younger than 70, with localized prostate cancer, less than 6 out of 9 positive biopsies) and PSA less than 20 ng/ml (Tandem) were selected for this intent-to-treat study. Seven of the 210 patients corresponding to the selection criteria presented with bone metastases and 4 of them had a PSA less than 10 ng/ml. None had lymph node metastases. The risk of bone metastases despite PSA less than 20 ng/ml is therefore not negligible. In our opinion, it is necessary therefore to continue to include bone scan in the staging assessment of clinically localized prostate cancer.