Risk factors for bone metastasis in patients with prostate cancer: a retrospective study based on single-center data and SEER database

Chin Clin Oncol. 2025 Apr;14(2):16. doi: 10.21037/cco-24-78.

ABSTRACT

BACKGROUND: Bone metastasis in prostate cancer (PCa) has been considered a significant determinant of both patient survival and quality of life. However, the factors contributing to the incidence of bone metastasis remain unidentified. This study primarily aims to elucidate the risk factors associated with bone metastasis in individuals diagnosed with PCa.

METHODS: A total of 177 patients who had undergone radical prostatectomy at our institution were included in the analysis. These patients were categorized into two groups based on the results of whole-body bone emission computed tomography (ECT) scanning: the bone metastasis group and the non-bone metastasis group. Univariate and multivariate logistic regression analyses were conducted to determine the independent risk factors for bone metastasis. Additionally, receiver operating characteristic (ROC) curves were employed to compare the diagnostic efficacy of the clinical variables. Additional data from the Surveillance, Epidemiology, and End Results (SEER) database, consisting of 96,497 patients, were analyzed for external validation.

RESULTS: The findings indicated that among the diagnosed patients with PCa, 18.64% (33/177) exhibited bone metastasis. Through multivariate logistic regression analysis, it was determined that prostate-specific antigen (PSA), Gleason score, percentage of monocyte (M%), and N stage were identified as independent risk factors for bone metastasis in PCa. The study found that the sensitivities for PSA and Gleason score were 66.67% and 69.70%, respectively, while the specificities were 85.42% and 65.97%, respectively. Additionally, the analysis of data from the SEER database confirmed that both PSA, Gleason score and N stage were independent risk factors. Furthermore, the Chi-squared test revealed a positive correlation between the primary histological grade and the rate of bone metastasis.

CONCLUSIONS: The present study ascertained that PSA, Gleason score and N stage served as prognostic indicators for bone metastasis in PCa. The investigation of the significance of M% and the primary histological grade in the diagnosis of bone metastasis in PCa warranted further exploration.

PMID:40337872 | DOI:10.21037/cco-24-78