Prognostic significance of complete blood count parameters in castration-resistant prostate cancer patients treated with androgen receptor pathway inhibitors

Quantitative assessment of 99mTc-methylene diphosphonate bone SPECT/CT for assessing bone metastatic burden and its prognostic value in patients with castration-resistant prostate cancers: initial results in a single-center retrospective study

PURPOSE

To evaluate the prognostic value of the quantitative assessment of ^99mTc-methylene diphosphonate (^99mTc-MDP) bone SPECT/CT in castration-resistant prostate cancer (CRPC) patients with bone metastases.

METHODS

A total of 103 patients who underwent ^99mTc-MDP bone SPECT/CT imaging from the neck to the proximal femur were included. First, in 65 patients without bone metastases, the normal range of standardized uptake value (SUV) of non-pathological bone was evaluated to determine an SUV threshold to reliably exclude most normal osseous activity. Then, in 38 CRPC patients with bone metastases, lesion uptake volume (LUV), which is the extracted volume of bone metastases exhibiting high accumulation above the SUV threshold, was calculated. The relation between LUV and prostate-related mortality was statistically evaluated.

RESULTS

Based on the SUV measurements of non-pathological bones, the optimal SUV threshold, which defines abnormal bone SPECT uptake, was determined to be 8. Median LUV was 39 mL (interquartile range 4.0-104.3 mL) in the CRPC subjects with bone metastases. Kaplan-Meier survival analysis showed a significant relation between prostate cancer-specific survival and LUV (cut-off value, 19.95 mL; P = 0.001). Multivariate analysis revealed LUV as an independent prognostic factor for the survival (P = 0.008, hazard ratio 23.424). Global chi-square test showed that LUV had significant incremental prognostic value in addition to prostate-specific antigen and the interval from progression to CRPC until bone SPECT/CT (P = 0.022).

CONCLUSION

Quantitative assessment of ^99mTc-MDP bone SPECT images can provide valuable prognostic information in CRPC patients with bone metastases.

Pre-treatment red blood cell distribution width as a predictor of clinically significant prostate cancer

OBJECTIVE

The present study aims to assess the relationship between red blood cell distribution width (RDW) and clinically significant prostate cancer (csPCa).

METHODS

A total of 458 patients with prostate-specific antigen (PSA) ≤ 10 ng/ml, who subsequently underwent 11-core transperineal template-guided prostate biopsy from June 15, 2015 to November 24, 2020, were included in the present study. Receiver-operating characteristic (ROC)-derived area under the curve analysis was performed to evaluate the predictive accuracy. In addition, univariate and multivariate logistic regression analysis was carried out to determine the association between RDW and csPCa detection.

RESULTS

A total of 89 patients were diagnosed with csPCa, and these patients presented with higher median RDW. The optimal RDW cut-off was set at 12.35%, which gained the maximal Yuden's index. In addition to csPCa, RDW demonstrated a positive correlation with age (r = 0.210, P < 0.001). It was observed that RDW was independent of prostate-specific antigen density for csPCa detection. Compared with the low-RDW group, patients in the high-RDW group had a 1.586-fold increased risk of being diagnosed with csPCa (OR = 2.586, P = 0.007). In the ROC analysis, the accuracy level increased by 3.1% for the prediction of csPCa, when RDW was added to the multivariate logistic model.

CONCLUSION

A high-RDW value is an independent risk factor for csPCa detection. However, more large-scale studies are needed to confirm these findings. If validated, RDW can become an inexpensive, non-invasive, and convenient indicator for csPCa prediction.